Injuries to the ankle are among the most common lower extremity sporting injuries. The ankle joint is a complex joint formed by three bones. It consists of the tibia which provides the major weight bearing surface where it joins the talus. The joint is saddle-shaped with the tibia contributing the medial malleolus and the fibula contributing the lateral malleolus. The weight bearing surface of the tibia and the inner aspect of the medial and lateral malleolus are covered with cartilage.
Ankle stability is conferred by the bony architecture as well as three distinct groups of ligaments: the syndesmotic ligaments, the lateral collateral ligaments, and the medial collateral ligaments. Sprains of the lateral ligaments of the ankle are the most common musculoskeletal injury in sports.
Patients with ankle sprains and fractures will have pain, tenderness, and swelling at the site of the injury.
In patients with ankle injuries, radiographs are taken in order to see if there is indeed an ankle fracture.
Most patients are placed in a splint or walking boot based on the injury pattern. Ankle sprains are most frequently treated without surgery. Initial rehabilitation consists of rest, ice, compression (elastic wrap) and protected weight bearing. For mild sprains, patients should discontinue the use of crutches as soon as they can tolerate full weight on the ankle.
Physical therapy consists of range of motion, exercises with isometrics and proprioceptive retraining. Bracing or taping are used when patients need to immediately return to their sport. For mild sprains taping and bracing can be discontinued three to four weeks upon returning to their sport. For more involved sprains, bracing or taping programs and supervised rehabilitation programs are continued for six months. A year after the injury, occasional intermittent pain is present in up to 40 percent of patients. Surgery is not usually necessary for ankle sprains, but can be recommended for patients with excessive hyper-mobility of the ankle joint.
Reviewed by health care specialists at UCSF Medical Center.