This is a very common sports injury which almost everyone will experience at some stage. When you “go over “ on your ankle the ligaments which bind the bones together are stretched forcefully and this can be very painful as these ligaments have lots of nerve endings. If the injury is severe there may be a lot of bruising and swelling. Often the sprain, while very painful at the time, settles down with rest and time depending on the severity of the injury. The ankle joint is integral to standing, walking and running but it has an additional role in balance and stability. The ligaments around the ankle have lots of specialised nerve cells called proprioceptors which continually monitor where your foot is in space. This information is fed up to your brain which then tells the muscles in your feet and legs when to switch on and off so that you don’t fall over! Under normal circumstances this happens so quickly that you are not aware of it. An ankle sprain disrupts the automatic signalling so that the response time is slower. This often means that the ankle feels unstable and it is more likely to be re-injured. It is always a good idea to have an ankle sprain checked out by a physiotherapist even when the pain settles down and it seems to have healed. The balance mechanism needs to be retrained so that it reacts automatically otherwise you are likely to suffer further sprains on that ankle.
David came for treatment to Stranmillis Physiotherapy having sprained his right ankle playing soccer almost a year before. At the time of the injury he had visited casualty and was advised to rest for a week or so. The pain settled down after about a week and David was able to return to playing soccer but the ankle felt a bit unstable at times. He noticed that he often went over on his ankle if walking on rough ground and it ached quite often especially in the mornings or after sport. He had stopped playing soccer a few months ago because he “didn’t trust” his ankle. A few weeks ago he had gone over on his ankle while out for a walk in the country and was worried that he had done serious damage to his ankle. On examination David’s balance on the right leg was markedly worse than on the left, his right ankle was stiff and he had muscle wasting of his right leg in general. Treatment involved mobilisation of the joints around his ankle, lots of work on improving his balance and specific strengthening work for his right leg. David had 4 treatment sessions spread over 3 weeks and was planning on resuming soccer after working on his general fitness.