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Ankle
Sprains - Causes & Risk Factors
A guide for the prevention and treatment of ankle injuries
Part 1
Ankle Injuries are one of the most common injuries
faced by anyone who participates in sport or exercise. As a
matter of fact, you don't even have to be engaged in any exercise
to suffer from a sprained ankle. It seems that even while minding
your own business, an ankle injury can occur.
Ankle injuries are commonly associated with
sports that require a lot of running, jumping and change of
direction. Excessive twisting or turning of the ankle joint
results in a rupture of the ligaments that hold the ankle in
place.
I've had many requests for an article on sprained
ankles, so to follow is the most comprehensive information I
could put together. In fact, I found it hard to fit it all into
one issue, so I've decided to split it into two parts.
In the first part, we're going to have a look
at exactly what a sprained ankle is. I'll go over the structures
that make up the ankle joint; we'll have a look at what happens
when an ankle injury occurs; we'll check out the symptoms associated
with an ankle injury; and then we'll finish off with a look
at the major causes and risk factors that contribute to ankle
injury.
In the second part you'll find the most complete
treatment, rehabilitation and prevention information available
anywhere. I'm going to outline a detailed, step-by-step process
of firstly treating the initial injury and then making sure
you never have to worry about ankle injuries again.
What is an Ankle Sprain?
An ankle sprain is an injury that results from
a twisting action, which stretches or tears the ligaments of
the ankle joint. (The term sPrain refers to an injury of the
ligaments, as opposed to a sTrain, which refers to an injury
of the muscle or tendon.) Remember; ligaments attach bone to
bone, were as tendons attach muscle to bone.
The foot and ankle joint is a very complex structure,
made up of many bones, ligaments, muscles and tendons. As you
can see from the diagram below there are many opportunities
for an injury to occur at the ankle.
When
an ankle injury does occur it usually affects one or more of the
ligaments that help to hold the ankle joint in place. However,
if the injury is severe enough damage may also occur to the tendons
that attach the muscles to the bones.
There
are a number of ligaments that keep the ankle joint in place
and prevent a loss of stability. The ligaments that are commonly
affected by an ankle sprain are the ones located on the lateral
side (or outside) of the ankle.
The
three major ligaments that help to stop the ankle from rolling
forward and outward are the anterior talofibular ligament, the
posterior talofibular ligament and the calcaneofibular ligament.
These
ligaments can be seen in the diagram to the right, and are located
at the bottom edge of the circle.
Injuries
to the ligaments of the ankle are usually graded into three
categories, and these injuries are referred to as: first; second;
or third degree sprains.
A
first degree sprain is the least severe. It is the result of
some minor stretching of the ligaments, and is accompanied by
mild pain, some swelling and joint stiffness. There is usually
very little loss of joint stability as a result of a first degree
sprain.
A
second degree sprain is the result of both stretching and some
tearing of the ligaments. There is increased swelling and pain
associated with a second degree sprain, and a moderate loss
of stability at the ankle joint.
A
third degree sprain is the most severe of the three. A third
degree sprain is the result of a complete tear or rupture of
one or more of the ligaments that make up the ankle joint. A
third degree sprain will result in massive swelling, severe
pain and gross instability.
One
interesting point to note with a third degree sprain is that
shortly after the injury, most of the localized pain will disappear.
This is a result of the nerve endings being severed, which causes
a lack of feeling at the injury site.
From
the explanations above you can see that pain and swelling are
the two most common symptoms associated with an ankle sprain.
You can also expect some bruising to occur at the injury site.
The associated swelling and bruising is the result of ruptured
blood vessels.
Causes
and Risk Factors
There
are a number of causes and risk factors associated with an ankle
sprain. One of the most common causes is simply a lack of conditioning.
If the muscles, tendons and ligaments around the ankle joint
have not been trained or conditioned, this can lead to a weakness
that may result in an ankle sprain.
A
simple conditioning program that helps to even out any imbalances
at the ankle will help considerably. For example, the calf muscles
may be much stronger than the muscles in the front of the leg.
This would lead to a strength imbalance. Or, maybe the Achilles
is very tight while the anterior muscles are very flexible.
This would lead to a flexibility imbalance. (In part 2, I'll
go into a lot more detail about conditioning and imbalances.)
A
lack of warming up and stretching is another major cause of
ankle injuries. In an article titled, "Ankle Injuries in
Basketball: injury rate and risk factors," by McKay, Goldie,
Payne & Oaks, in the British Journal of Sports Medicine;
the article states that "Basketball players who did not
stretch during the warm up were 2.7 times more likely to injure
their ankle than players who performed stretches."
There
is also a number of other less common causes of an ankle sprain.
They include things like wearing inadequate footwear, running
or training on uneven ground, and simply standing on, or in
something you're not meant to.
However,
the most common risk factor associated with ankle sprains is
a previous history of ankle sprains. In other words, if you've
had an ankle injury in the past, chances are you're going to
suffer another one if you don't take some precautions and do
some conditioning exercises to strengthen your ankle.
Gail
McKay, in a recent Sport Health article titled "Risk Factors
for Ankle Injuries" stated; "The most common risk
factor identified was a history of ankle injury. Therefore,
ankle-injured athletes tend to face the downward spiral of recurrent
ankle injuries. Hence, ankle injured athletes should be encouraged
to undertake comprehensive ankle rehabilitation programs."
In
part 2
that's just what we're going to do. I'll be outlining a comprehensive
initial and ongoing treatment program.
Click
Here For Part 2
Article
by Brad Walker. Brad is a leading stretching and sports
injury
consultant with over 15 years experience in the health and
fitness industry. For more articles on the prevention & treatment
of sports injury, subscribe to The Stretching & Sports
Injury Newsletter by visiting http://www.thestretchinghandbook.com
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