Hello and welcome back to the ThreeSpires Physiotherapy blog where we discuss all things physiotherapy related. In the last of our physiotherapy blogs we looked at the anatomy of the ankle joint as a starting place for looking at ankle injuries. Certainly, as physiotherapists we see a large number of ankle injuries ranging from full ankle fractures to ligament strains but in this blog I think it would be best to leave ankle fractures for another blog and concentrate on ligament injuries.

Okay, so let’s have a look at the most common injuries that we as physiotherapists see at the ankle. First thing to note is that by far the most common cause of ankle injuries is a sporting injury from a sport that involves lots of stop start and twisting and turning such as football. Then next point to note is that lateral ankle (the outside of the ankle) strains are much more common than medial ankle (inside of the ankle) strains.

So, let’s have a look at lateral ankle sprains and injuries. Due to the amount of inversion (inward twisting of the foot) possible and the general bony mechanics of the ankle the ligaments on the outside of the ankle are much more likely to be injured. The most commonly injured part is the anterior talo-fibular ligament (ATFL) which joins the fibula and talus together. When most people describe “going over” on their ankle this is the area that is most likely to be damaged. If you injure this ligament usually you will experience immediate swelling and very sharp pain with potentially some bruising. One important point to note is that if you have gone over on your ankle and you can’t stand on it and take a few steps, you likely need an x-ray to rule out a fracture. Another important point to note is that lateral ankle sprains take a long time to fully recover from: at least 6 – 8 weeks and probably longer depending upon the severity. To help your recovery it would generally be advisable to see a physiotherapist as soon as possible.

It is also possible (but much less common) to injure the inside part (medial) of your ankle. However this is not very common due to the mechanics of the ankle and also the fact that the deltoid ligament is very strong. In fact if you injure this part you almost certainly need an x-ray as an injury to the deltoid ligament of the ankle will often pull a part of the bone off rather than rupture the ligament! Again swelling, pain and bruising are very common symptoms and rehab/recovery times are quite long.

Lastly we have what are called “high ankle sprains” which in general are attributed to the joint between the tibia and fibula called the ankle syndesmosis and damage to the ligaments that make up this joint. Injuries here are much less common than lateral ankle injuries and are generally seen from a twisting a rotating force. These can be common in footballers and in any sport where there can be a large amount of rotational force at the ankle. Symptoms can range from very mild to severe feelings of instability at the ankle.  

With all the ankle injuries described above I would strongly recommend that to improve your chances of a good return to sport or normal activities you should see a physiotherapist. If you live in any of the following areas our physiotherapists would be able to see you at home in Lichfield, Sutton Coldfield, Tamworth, Cannock, Walsall and Rugeley.

For anyone reading this blog for the first time: we are a home visit physiotherapy service, based in Lichfield and serving Sutton Coldfield, Tamworth, Cannock, Walsall and Rugeley.