The ankle joint comprises three bones, the tibia, the fibula, and the talus. These bony components are supported by multiple ligaments that can be divided into three groups: the lateral ligament complex, the medial deltoid ligament, and syndesmotic ligaments, which keep intact the tibia and fibula where the joint forms. These ligaments attach bone designs and give stability to the joint.
The ankle is described as a hinged joint that is responsible for upward motion (dorsiflexion), downward motion (plantar flexion), inward rotation (inversion), and outward rotation (eversion) of the foot. The ankle joint is crucial for ambulation because it allows the foot to adapt to the surface it is walking on and can sustain loads as much as multiple times the body’s weight.
LOW ANKLE SPRAIN (COMMON ANKLE SPRAIN)
At the point when physicians allude to ankle sprains, they are describing injuries to the ligaments that attach the bones of the ankle joint. An ankle sprain can happen to either the ankle’s inside (medial) or the outside (lateral) ligaments. These designs may stretch and tear when the joint is forced into an unnatural position. The most common mechanism of injury to the ankle joint is an inversion of the foot which mainly affects the three ligaments that form the lateral ligament complex. These are the anterior talofibular ligament (ATFL), the posterior talofibular ligament, and the calcaneal fibular ligament. With a typical ankle sprain where the foot is forcefully inverted, the ligament that experiences the most damage is the ATFL. Many low ankle sprains are because by forceful inversion, and the remainder is because by forceful eversion, which affects the medial deltoid ligament. The seriousness of the sprain corresponds to the level of involvement of these three ligaments. A grade I ankle sprain involves the ATFL alone, a grade II sprain involves two ligaments, and grade III involves all three.
Diagnosis of ankle sprains depends mainly on patient history, physical exam findings, and imaging (X-rays, CT, MRI) to preclude fractures and other locales of injury and assess seriousness. People who experience a low ankle sprain injury will regularly have pain with weight-bearing, swelling, solidness, and in any event, bruising in more severe sprains. Also, there is usually an area of delicacy which corresponds to the injury site; on a physical exam, joint laxity may be seen on the corresponding ligament.
HIGH ANKLE SPRAIN (SYNDESMOTIC ANKLE INJURY)
In contrast to low ankle sprains, a high ankle sprain happens when shearing damage is done to the syndesmotic ligaments. These ligaments keep the tibia and fibula above the talus intact. While bearing load on the leg, the tibia and fibula experience strong forces that spread them apart. The syndesmotic ligaments, or syndesmosis, act as shock-absorbing cables that keep these two bones from spreading too far apart. High ankle sprains commonly happen when the foot and ankle rotate together, such as unexpected twisting, turning, or cutting motion in high-impact sports like football, basketball, and soccer.
Diagnosis of a high ankle sprain is based on patient history, physical exam, and imaging to preclude fractures or compartment condition. High ankle sprains may be frustrating for patients because they don’t “look that bad” clinically, meaning that they don’t cause as much swelling or bruising as seen with low ankle sprains. Because of this, patients can become unaware of the seriousness of their injury, which can eventually affect the recovery and healing cycle. In any case, people who experience high ankle sprains may have extreme pain that radiates up the leg with each step and can become worse while doing developments similar to how the injury happened. On physical exam, there is the provocative test that may be unlawful pain, such as the press test (compressing the tibia and fibula at midcalf) and external rotation stress test (external rotation/dorsiflexion of the foot with knee and hip flexed at 90 degrees).
TREATMENT AND RECOVERY
Immediately after an ankle injury, the most critical factor will be rest. Once doctors diagnose a sprained ankle, the person should rest for a few days. A few home cures may aid recovery. Elevating the foot may help reduce swelling. Placing an ice pack wrapped in a towel on the area for about 10 minutes every few hours can also help reduce swelling and pain. Over-the-counter (OTC) drugs, such as ibuprofen (Advil) or acetaminophen (Tylenol), can also help with the pain. A few rest days are usually enough for most people with mild to moderate sprains. After a few days, the person may begin gentle exercises to help rehabilitate the ankle. Healing of the ligaments usually takes about six weeks.
Whether a low ankle sprain or a high ankle sprain, conservative treatment for the two sorts of injuries include: RICE protocol (rest, ice, compression, elevation), NSAIDs for pain and anti-inflammatory help, and physical therapy to regain motion and functionality, further treatment options will significantly rely upon the seriousness of the injury. In the case of low ankle sprains, ankle braces may help give additional stability to the joint and forestall future sprains, especially in patients with a history of repetitive sprains. On the other hand, high severe ankle sprains may require a non-weight bearing walker boot or cast for a few weeks to delay weight bearing until healing follows. The medical procedure is not considered if there is proof of a total tear or fractures.
Recovery from an ankle sprain will also rely upon seriousness. A grade I low ankle sprain can completely recover in days to two or three weeks, while a grade III sprain can take as long as twelve weeks. In the case of high ankle sprains, they generally require a longer recovery and rehabilitation period compared to low ankle sprains. It can take anywhere from six weeks to three months and, at times, much more. The key to effective recovery is to allow healing to happen without applying extreme weight on the ankle, and with legitimate therapy and exercise, regain strength and functionality back to normal. Are you searching for the best physiotherapy doctor to defeat all your issues? Contact Dr. Niraj Patel (physiotherapist).