A few posts back, I said I would outline some important points you want to be thinking about if you have an acute ankle sprain, as well as what you can do if you already ARE someone with a "bad ankle".
Even if this isn't your first rodeo when it comes to ankle sprain, I would encourage you to read this post as every time you injure your ankle will little different from the last!
The first place to start when it comes to ankle injury is just how serious is it?
So what can go wrong?
We all know its sore, and we have all seen a puffed up and inflamed ankle, but what exactly is going on when you injure it?
By far, the most likely mechanism of injury in an ankle is rolling outwards or "over the top" of your ankle. This direction of movement accounts for the Anterior Talofibular Ligament (literally meaning, the ligament at the front that connects your ankle bone of your foot, or Talus, to the bone that runs on the outside of your lower leg making that bump on the outside of your ankle, your fibula) being the most commonly injured tissue in an ankle sprain injury.
In my opinion, it is this injury to ligaments that causes ongoing issues in regard to ankle sprain, as ankles can take 12- 24 MONTHS to heal completely (depending on the severity of injury) and most people don't continue their specific rehab for long after the ankle is no longer in pain, which is usually much faster than this. This lack of correct rehab leads to other issues longer term.
What else can be injured?
Beyond the Anterior talofibular ligament, other sites on injury can include the ankle cartilage or even in more extreme cases, fracture of the fibular or the foot itself!
When do you need to X-ray?
There are various factors to take into consideration when determining if you need an X-Ray of your injury.
Some are best assessed by a health care professional such as exactly where it is sore, what type of pain do you have, as well as the exact mechanism of the injury.
As a general rule though, if you have injured your ankle and you are trying to decide if you should go to the emergency department, the best thing to ask yourself, according to the Ottawa rules for determining need for X-ray is this:
- Could I weight bear immediately after the injury occurred?
- Can I walk at least 4 steps now?
If either of these are a yes, it is likely a radiograph will be warranted and I would recommend either contacting your health practitioner and letting them know, or visiting the emergency room immediately.
But if there is no fracture, what else can go wrong?
As discussed above and in a previous post, a major issue can be the damage to relevant ligaments, but there is yet another structure that can be affected by intense or repeated ankle sprain, and thats cartilage.
The cartilage in your ankle is special in that it possesses healing and regenerative properties that are better than many other areas of your body, to account for extra stress in such a mobile weight bearing joint. Yet, even this area can be permanently damaged.
Due to the healing, the ankle is an unlikely region to suffer from arthritis as a primary issue, but is one of the MOST likely joints in the body to develop arthritis in response to an injury as secondary symptom. Another reason that ongoing and thorough management and rehab is paramount to insult to the ankle!
When can I be back on it and how much can I do?
This is the most important question in getting you (for want of a better term), back on your feet. The main area of focus is OPTIMAL LOADING. Not too much too soon injuring you further, and not too little so as to hamper your recovery.
This is best assessed in person with your health care practitioner.
If you have any concerns about your ankle, or you re not sure who you SHOULD be seeing about your injury, please do not hesitate to contact us at Align, we would love to help you be back up and running as soon as possible.