There are so many different types of ankle sprain. So many different structures that can be affected and so many degrees of injury. Ever heard the commentators talking about players being out for 12 weeks with a high ankle sprain? Others are back in a few short weeks following a “simple” ankle sprain.
Here are some pictures of your ankle anatomy.
It is easy to see the lateral ligaments (on the outside of the ankle) are small (and multiple). The inside ligaments are thick and substantial.
The most common sprain injury is to the ATFL (anteriortalofibular ligament) that is shown by the arrow in the first picture. It is this ligament that helps to limit the amount your ankle rolls out and points down. This type of injury makes up 70-85% of ankle sprains we see.
Less commonly but more seriously are the syndesmosis injuries. These are known as high ankle sprains. This ligament (s) holds your two shin bones (tibia and fibula) together above your ankle. Injury to these ligaments occurs as you suddenly twist while your foot is planted on the ground.
A high ankle sprain results in pain above your ankle joint centrally. Often a weight-bearing x-ray is required to assess the degree of injury (and if more invasive treatment is required). Treatment of these injuries can require a boot for up to 6 weeks, return to sport doesn’t often occur before 3 months.
It is your physio’s role to adequately assess your injury to help diagnose the extent of damage. Listen to their advice, as disappointing as it can be when it means missing sport/exercise. Ligament damage is difficult to heal well, do it right the first time to prevent re-occurrence.
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