Ankle Injuries

Ankle Injuries: The Types, Causes and Treatment


Ankle injuries are very common and most of us will suffer at least some form of mild ankle injury in our lifetime.

They can occur from simple activities like just walking on an uneven surface, wearing unstable or high-heeled footwear, or tripping over something.

More commonly ankle injuries can occur during physical activity, specifically cross-training sports where the participant is required to change direction at speed.

It is fairly common in younger individuals who tend to be a lot more active, however ankle injuries can affect those of all ages.

There are various types of ankle injuries, dependent on their severity, which will determine the appropriate treatment and management.


Types of ankle injuries

  1. Minor Ankle Sprains and Strains or “Grade 1” injuries
    This form of injury refers to one that occurs when there is an overload of stress is placed on the ankle joint, resulting in stretching and some minor damage to the tendons and ligaments that hold the joint together. It can occur during a variety of activities. This type of ankle injury usually settles quickly with RICE, conservative treatments and simple exercises.
  2. “Grade 2” Ankle Sprains
    This involves a more severe sprain where a partial tear of a ligament occurs. This results in laxity or abnormal, excessive movement around the joint. These injuries are usually more painful and require a longer period of rehabilitation and recovery. Treatment usually requires a period of immobilisation and physical therapy to appropriately rehabilitate the injured ankle. This reduces the likelihood of future injury.
  3. “Grade 3” Ankle Sprains
    This type of ankle injury results in severe pain, instability and swelling around the affected ankle. Grade 3 ankle sprains involve a full tear or rupture of one or more of the ankle ligaments. Occasionally this may also be accompanied by a fracture of the bones surrounding the ankle. These ankle sprains require aggressive treatment and may at times require surgical intervention. A long rehabilitation process is required to ensure a strong, stable ankle is achieved.


Common Causes of Ankle Injuries

These have been briefly mentioned above, but a list may help –

  1. Falls from a height onto the feet or ankle
  2. Tripping over something or slipping on a surface
  3. Walking on an uneven or steep surface
  4. Sports injuries from sports like football and basketball – usually result from changing direction or landing awkwardly after a jump.
  5. Unstable footwear such as high-heels

Patients who suffer from ankle injuries often have a great deal of pain and swelling in the affected ankle. On occasion, there can be some bruising around the site, especially if some underlying blood vessels have burst.


Ankle Injury Diagnosis

It is mostly from clinical history and examination.

X-rays and ultrasound imaging are very useful to assess whether there is an underlying fracture or ligament rupture.

In some cases MRI may be utilized to see the full extent of damage.


Ankle Injury Treatment

Podiatrists manage ankle injuries on a daily basis, and always offer the ‘RICE’ advice. This includes

  1. Rest
  2. Ice application – Apply locally to the affected joint for short periods of time (10-15mins, 3-4x per day). Avoid prolonged use as this can cause injury to the surrounding skin.
  3. Compression – Wrapping the area with compression bandage reduces the development of oedema or swelling and helps it to settle quickly. These are done with elastic bandages that are available at any chemist or pharmacy. It is advised that the compression bandage be wrapped from the ball of the big toe (forefoot) up to the calf, above the ankle. This ensures that any swelling does not occur in the foot. Ensure that it is not wrapped on too tight.
  4. Elevation – Keeping the foot elevated above the level of the hip ensures that the swelling goes down.


Alternative Ankle Sprain or Injury Treatment

There are a number of other ways to manage ankle injuries. Splints or supports may also be prescribed by the treating podiatrist or physiotherapist.

This may be simple taping, a sports ankle brace, or in severe cases a CAM boot.

This maintains the ankle in a position of least stress, and thus helps reduce pain and swelling and recovery of full movement.

Following treatment of ankle injuries, a period of physical therapy may be required to ensure full joint movement and mobility, with the ability to bear weight on the joint again.

This program will include ankle strengthening exercises such as moving the ankle up and down, side to side, and in a rotating motion.

Resistance to these movements, plus a functional program will be added as the ankle improves.

Ankle stretches will also be demonstrated. All these help strengthen the ankle back to its normal level over time.


Prevention of ankle injuries

Unfortunately, accidents happen. However, precautions can be taken such as being cautious when walking briskly or on a wet surface, and wearing preventative ankle braces when participating in sports.

In case of injury, always follow R.I.C.E.


Further information on Ankle Sprains and Injuries


Conclusion on Ankle Sprains & Injuries

Ankle injuries are common, and podiatrists are here to help. Simple home remedies can help treatment, though in some cases, specialist treatments may be required.