A sprained ankle is the stretching or tearing of ankle ligaments, which support the joint by connecting bones to each other. A sprain occurs when your ankle is forced to move out of its normal position, which can cause one or more of the ankle’s ligaments to stretch, partially tear or tear completely.

Sports injuries happen often in ankles and feet and there’s lots of soccer players and almost every athlete in the province at some point has sprained their ankle.Most of the time these sprains can be treated by bracing, physiotherapy, ice and 99 percent of them get better. On occasion, they don’t get better and there’s reasons within the ankle or around the ankle that that might happen.

If you look at the ankle, there’s a number of places that can get injured after a sprain or sports injury. When the ligaments on the outside of the ankle get torn or broken, the ankle becomes unstable and these may need to be repaired.

Within the joint, however, if you have recurrent sprains, the joint surface can get damaged by the sprains and as a result, there can be holes within the cartilage that can cause a lot of discomfort. After an ankle sprain, you can end up rupturing the tendons that are on the outside of the ankle that go between the fibula and the talus or the fibula and the calcaneus. And this can cause ongoing instability in your ankle but each time you roll your ankle, you can damage the cartilage within the ankle joint.

Sometimes these can repair, sometimes they remain unstable. The cartilage damage, however, often needs surgical treatment and the cartilage damage affects the talus either on the top side on this shoulder or on the top side on this shoulder there.

On occasion, it’s beneficial to put a scope into the joint and clean up those areas of damage so that they hopefully stop hurting you. If you have one of these holes however with an unstable ankle, it’s a good idea not only to look inside the joint with the arthroscope, but also to try and repair the ligaments on the outside of the ankle to make sure that the ankle is stable and that you don’t continue to roll it and damage the cartilage within the joint.

So with these types of injuries, you may need to talk to your physiotherapist or your coach or your family doctor to see how you can make sure that you’re getting the best treatment for your foot injury.

And on occasion, your family doctor may choose to send you onto an orthopedic surgeon who may be able to help you with an operation to try and improve the function of your foot for sport. Often seeing a local family physician or a physiotherapist in conjunction with a registered dietitian and athletic therapist is a great option to take control of this condition. Smart Food Now and exercise is also optominal for overall health.    

Presenter: Dr. Alastair Younger, Orthopaedic Surgeon, Vancouver, BC

Now Health Network Local Practitioners: Orthopaedic Surgeon

One variant of the typical ankle sprain, which is more serious, is the high ankle sprain.So this involves a sprain of different ligaments. These are the ligaments that attach these two bones together, so the tibia and the fibula, and also the ligament that wraps around the front of the ankle and holds the tendons in place.

When those ligaments are sprained, it can make the entire ankle complex unstable causing these bones to spread apart from one another. So in a third degree or complete tear of those ligaments, a screw needs to be placed across these bones in order to hold them back together.

Most high ankle sprains that are less severe will require a few weeks of not bearing weight on the foot. So typically people will have to use crutches. Once you’re allowed to bear weight, then it takes somewhere between four and six weeks to be able to go back to do most of your normal activities.

With more serious injuries that requires surgery, you may not be weight-bearing for up to six weeks and then another six to 12 weeks after that before you can resume activity. The typical treatment for lesser sprains would include ice, anti-inflammatories, physiotherapy, and of course in terms of diagnosing these injuries, sometimes you will need an x-ray.

There are times where these kinds of injuries are hard to pick up even on an x-ray, and we may need to do an MRI, for example. The best way to prevent these kinds of injuries typically would be to make you’re doing a good ankle strengthening and balance program in advance of starting your season.

If you think you have a high ankle sprain or have more questions, you could consult a sports medicine physician or a physiotherapist.

Presenter: Dr. Grant Lum, Sports Medicine Physician, Toronto, ON

Local Practitioners: Sports Medicine Physician

Ankle sprains are one of the most common injuries faced by dancers, particularly a sprain to the outer or lateral stabilizing structures of the ankle. It often occurs when the foot inadvertently rolls in, maybe from landing a jump or a leap.

Symptoms such as swelling, bruising, and an inability to bear weight, together with pain, suggests a disruption to the integrity of the stabilizing ligaments on the outside aspect of the ankle.In treating this condition, often seeing a local massage therapist for muscle tension, a local personal trainer for muscle strength and a physiotherapist for release and conditioning is a good option.  

Ankle sprain treatment depends on the severity of the sprain. As with other injuries about a joint rest, ice, compression and elevation of the joint are the cornerstones of therapy. The severity of the sprain will dictate the amount of protection and immobilization that is required for the ligaments to heal.

After the acute phase, a program of stretching and strengthening is very important in order to restore the mobility, balance and strength of the ankle joint itself. In addition to physiotherapy, some of the solutions during treatment while one recovers from this injury as well as for prevention include taping and bracing.
If you feel you have suffered this injury or have any further other questions about lateral ankle sprains, please don't hesitate to contact your local sport medicine physician or family physician.

Presenter: Dr. Larissa Roux, Sports Medicine Physician, Vancouver, BC

Local Practitioners: Sports Medicine Physician