Ankle Sprains with ankle sprains accounting for 36 percent of all injuries in soccer, it is important to understand the various mechanisms of these injuries. This will aid in determining proper rehabilitation techniques to return athletes back to competition as quickly and safely as possible. The mechanisms of injury are most often running or tackling. Eighty percent of first-time ankle injuries occur while tackling. In the cases where running was the mechanism of injury, there was a high incidence of previous ankle injury. An ankle sprain in many instances can be worse than a fracture in terms of complete recovery. Whereas fractures are immobilized and progressed gradually while they heal, quite often ankle sprains are rushed through the rehabilitation process, and the athlete returns to the sport before he or she has adequate strength and proprioception. This can lead to chronic swelling and instability of the ankle. The athlete may be hampered by this ankle injury for an entire season if proper treatment is not received.

An inversion sprain is the most common type of sprain. One or two ligaments are commonly involved in inversion sprains. The most common ligament injured is the anterior talofibular ligament (ATFL). The second most commonly injured ligament is the calcaneofibular ligament (CFL). An eversion sprain is fairly uncommon due to the bony configuration of the ankle mortise. In addition, the foot would have to be forced outward for this injury to occur. This position would stress the strong deltoid ligament on the medial side of the ankle and often leads to an avulsion fracture of the tibia.

The health care provider can grade ankle sprains based on the severity of injury. A grade 1 sprain is most common and usually involves the ATFL. There is minimal or no ecchymosis, minimal loss of function, mild pain and disability, and point tenderness over the ATFL. An anterior drawer test is negative on such an individual. A grade 2 sprain usually involves partial tearing of the ATFL and CFL. Pain is moderate, point tenderness is noted on palpation, ecchymosis appears 2 to 3 days after the injury, and the anterior drawer test elicits some excessive motion. A grade 3 sprain can involve the ATFL, CFL, and PTFL. Swelling is diffuse over the lateral aspect of the ankle, pain is moderate to severe, function is greatly limited, and anterior and posterior drawer tests are both positive. Frequently, there is tenderness to palpation of the medial ligaments as well.

Page: 1 - 2 -