Orthopaedics 360
The majority of ankle sprains occur following a twisting injury. Typically this is an ‘inversion’ type injury where the ankle turns inwards and the body ‘goes over’ the ankle joint. This pattern results in injury to the outer (lateral) sided ankle ligaments (ATFL / CFL).
There are varying degrees of severity of ankle sprains, depending upon whether the torn ligament/s is a partial or complete tear, and how many of the ligaments are involved.
Anatomy of the Ankle Ligaments
The ankle joint itself is made up of the two bones in the lower leg (tibia and fibula) and the talus (large bone that connects to both the tibia and fibula). The joint is stabilised by surrounding ligaments that provide stability. These ligaments are comprised primarily of lateral (outer) sided ligaments and medial (inner) sided ligaments.
The lateral (outer) ligament complex is formed by three distinct ligaments.
Anterior Talofibular Ligament
Calcinofibular Ligament
Posterior Talofibular Ligament
The Medial (inner) ligament complex is called the ‘Deltoid‘ ligament. The deltoid ligament is a broad ligament with attachment from the lower part of the tibia (medial malleolus) and spans out to several of the small bones of the foot.
Ankle Instability – Making the Diagnosis
Do you experience any of these?
Often a detail history is all that is needed to make the diagnosis of an unstable ankle joint. A patient who has had one or several ‘twisting’ ankle sprains, and who has the ongoing sensation that her ankle is going to collapse on them, has functional ankle instability. A thorough examination is performed to not only assess the integrity of the ankle ligaments, but to also exclude any additional injuries to the surrounding cartilage and tendons.
A plain xray will assess for small bone fractures and any evidence of arthritis around the ankle joint. A MRI scan can give detailed information regarding the joint cartilage surface and the surrounding ligaments and tendons.
Ankle Sprains
What are you injuring?
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Recurrent Ankle Sprains Can Cause Arthritis
Initial Management
Have you tried this?
The majority of ankle sprains (up to 80%) will heal well with conservative management. To achieve the best outcome, an active physiotherapy program should be commenced.
Functional Rehabilitation
Early mobility +/- supportive orthosis
Gait Retraining
Proprioceptive Training
i.e Wobble board exercises to teach the ankle joint to stabilise itself
Range of Motion Exercises
Peroneal Muscle Strengthening
To reduce the risk of long term stiffness
Ankle Ligament Stabilisation
Specialised sports reconstruction – Day Procedure
This technique is used to strengthen the outer (lateral) ligaments of your ankle joint. A keyhole arthroscopy is commonly performed at the same time to address any issues inside the ankle joint.
Do you experience any of the following?
Frequent Ankle Sprains
Pain in your ankle
Swelling around your ankle
Ankle sprains and arthritis
People don’t generally tend to associate ankle sprains with ankle arthritis due to its seemingly innocuous presentation in comparison to ankle fractures or dislocations, however recurrent ankle sprains can result in serious trauma to the ankle. Post traumatic...
A seemingly simple ankle sprain can lead to ankle arthritis
Ankle arthritis is less common that Hip and Knee arthritis. In fact, while Hip and Knee arthritis is commonly attributed to genetics and ‘wear and tear’ with increasing age, the ethology of ankle arthritis is often quite different. The most common cause for someone...
Ankle Impingement
Ankle impingement is a common cause of ankle pain. We discuss what causes ankle impingement here.
Disclaimer: Please note that this is general advice only - for more information, please consult your regular doctor, or obtain a referral to see a specialist orthopaedic surgeon.
Orthopaedics 360
Orthopaedics 360
P: (08) 7099 0188
F: (08) 7099 0171
Southern Specialist Centre
Orthopaedics 360
P: (08) 7099 0188
F: (08) 7099 0171
Health @ Hindmarsh
Orthopaedics 360
P: (08) 7099 0188
F: (08) 7099 0171