I am sure that you have twisted your ankle at some point in your life and you got a nice swelling with wonderful colours (yellow, green and purple). Well, you sprained your ankle. Ankle sprain is an injury which affects your ankle ligaments. There are mainly three types of ankle sprain: lateral ankle sprain, medial ankle sprain and high ankle sprain. The lateral one affects the lateral ligaments of your ankle (outer ligaments) and it is caused by a movement called inversion ( your ankle rolls outward and the foot turns inward) which will put a lot of stress on the ligaments, damaging them. The medial one affects the medial ligaments of your ankle (ligaments on the inside of your ankle) and it is caused by a movement called eversion ( your ankle rolls inward and the foot turns outward). The high one will affect the ligaments that join together your leg bones (fibula and tibia).
Note that inversion and eversion are physiological movements and they will cause injuries only in few cases, usually when these movements occur unexpectedly and bearing your body weight.
In this article I am going to focus on the most common ankle sprain, the lateral ankle sprain, the one that involves the outside of your ankle. Although ankle sprain is supposed to be a minor injury, sometimes it becomes a chronic problem which causes you pain and weakness and makes you struggle when exercising. This shouldn’t happen with a good treatment which should make you fully recover and at the same time prevent ongoing ankle problems. So, it is not just about recovery, but also about prevention.
Another thing you need to know, before I keep talking about this injury, is that on the outside of your ankle you have three ligaments (although some people refer to them as an unique big ligament):
- Anterior Talofibular Ligament (ATFL): It goes from your fibula (bone on the outside of your leg) to your talus/astragalus (bone under your leg bones).
- Calcaneal Fibular Ligament (CFL): It goes from your fibula to your calcaneus (heel bone).
- Posterior Talofibular Ligament (PTFL): It goes from your fibula to your talus (at the back of your ankle).
Classification of lateral ankle sprain
There are different ways to classify ankle sprains and I am going to show you the one I find easier to understand for everyone. This classification is based on how badly the ligament is damaged and whether or not the ankle joint has been made unstable.
- Ankle sprain Grade I: Mild damage of a ligament without joint instability. Mild tenderness, swelling and stiffness are usually present. Walking is usually possible, although it might be a bit painful.
- Ankle sprain Grade II: Partial tear of the ligament but without joint instability. More painful than the previous one and with more swelling and stiffness. Walking is painful.
- Ankle sprain Grade III: Complete tear of the ligament with instability of the joint. Severe swelling and pain. Walking is not possible because of the pain and instability.
Signs and symptoms of ankle sprain
- Pain: This pain is going to vary depending on the grade of the ankle sprain, from mild to severe.
- Inflammation: Your ankle might get inflamed which means that you will get redness, warmth, swelling and loss of function. Check out this blog post to understand what inflammation is about and this one to know the difference between inflammation and swelling.
- Bruise: It is also referred to as ecchymosis. It would be the colour you get with its different changes.
- Sensibility affected: This is due to the inflammation which increases the pressure in the area.
- Stiffness: Mainly after some time without moving your ankle.
- Limited range of motion: All movements are going to be limited, although the most restricted (as it will cause pain) is ankle inversion.
- Instability: When the ankle sprain is a severe one.
- Difficulty or impossibility of bearing your weight: The more severe the ankle sprain, the more difficult to bear your weight and walk.
- Pop sound in some severe ankle sprains.
You might like to read another blog post related to this one: Ankle sprain: risk factors and diagnosis.
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If you have any questions, do not hesitate to contact me on The Physical Therapy, Physiotherapy Clinic in the city of Souhampton, and I will be happy to help you.