Acute Lateral Ankle Sprain and When to Return to Sports

Lateral ligament injuries are quite common among athletes. While they do occur among average folks, the vast majority of cases treated by a physiotherapist in Waterloo are incurred during strenuous physical activities, the kind usually performed by those engaged in rigorous sports. Statistical data indicates that its occurrence between the two sexes is approximately the same though for young female athletes the rate is higher than for young male ones.

Lateral ligament injuries occur when the ankle is forcibly extended beyond the range permitted by the ligaments holding it in place. The human ankle consists of numerous ligaments, chief among them is the lateral ligament of the ankle. Ankle ligaments like the calcaneofibular ligament (CFL) help to move the foot inwards (inversion) and outwards (eversion).

Acute lateral ankle sprains occur when the foot movements (inversion and eversion) extend beyond the natural range of motion of the supporting ligaments, causing excruciating pain. Such individuals are not able to support their body weight on the injured foot.

These injuries have a high rate of recurrence.

Returning to sports and other regular physical activities can be a daunting task. This is because standard medical practice does not have clearly laid out criteria for determining complete recovery from these injuries. As such, physiotherapists and other healthcare professionals often rely on their own experiences to give athletes the okay to resume their physical activities. This lack of an established guidebook alone accounts for a significant number of cases of recurrence of these injuries and their ongoing symptoms like ankle instability and niggling pain.

To give an athlete the all-clear to return to their activities, healthcare professionals must consider these factors: 

Pain

The severity of pain (or total lack thereof) is usually a reliable indicator of how far the healing process for an acute lateral ankle sprain is. If the ankle is still painful when weight is put on it then it’s likely the athlete is not ready to get back into action. This should factor in the period from the time the injury was sustained. Pain sensation over the 24 hours prior to the assessment should be a key consideration.

​Ankle Impairments

A normal ankle should be able to extend through a certain range of motion. If such a range cannot be achieved without pain after sustaining the ankle injury then recovery is still in progress. As such, the athlete shouldn’t be cleared to engage in sports activities. Muscle strength and endurance are crucial too. The physiotherapist or medical professional assessing such injuries should pay close attention to how well the ankle responds to firm pressure. 
A gentle but firm grip should be able to confirm this. If the ankle is still sore to the grip then the athlete isn’t ready for physical exercises yet.

​Sensorimotor Control

This refers to proprioception, the ability to control one’s body position and certain movements. Needless to say, normal proprioception should be present in a healthy athlete, involving all parts of their bodies. In the case of an acute ankle sprain, this can mean an inability to balance on unstable surfaces. Assuming there is no pain in the ankle joint, the athlete should perform some landing and jumping movements in a random pattern. Inability to do this indicates that such sensorimotor control is still unstable, meaning the athlete needs more time for recovery.

​Functional Performance

The aim of clearing an athlete to return to performing sports activities is to enable them to compete in whatever it is they’re engaged in. As such, a reliable criterion for gauging the progress and recovery of an acute lateral ankle sprain is to make the athlete perform a full training session. During this session, the physiotherapist should pay close attention to any signs of discomfort when the athlete puts weight on the healing ankle.

Short sprints and other specific physical activities like jumping and hopping are a good way to see how the athlete’s ankle stands up to the rigors and strain of intense physical activities. If the athlete plays a particular sport like basketball, giving them game time will provide better conditions for a much more accurate assessment of their recovery. This is because they won’t be consciously thinking about their recovering ankle. Whatever moves they execute will be done in their natural element, hence providing an accurate assessment.

​Athlete Perception

Psychology is a very powerful factor in sports activities. This is especially true for professional and elite athletes. An athlete’s mindset and confidence are key to their performance. After an injury, many athletes experience a sort of “mental block.” This is when the brain has difficulty mustering confidence and motivation past a certain point. If the athlete was injured due to a nasty tackle from an opponent on the playing field, this mental block can become an issue if not handled well. While the healing of ligaments and muscles of the ankle is key to recovery, the mental aspect can be just as crucial.

When assessing recovery from an acute lateral ankle injury, the physiotherapist should take the mental and psychological components into account. A psychologist is especially useful in situations where the physical injuries have healed but the athlete is reluctant to get back to full training sessions. A good strategy would be to set small, attainable practice goals for the athlete to achieve. Gradually, the intensity and complexity of such physical activities can be ramped up. This helps to ease the athlete into the thick of things, thereby eroding the mental barrier slowly.
Physicians grade ankle sprains into grade I, grade II, and grade III, with grade III being the most severe.

On average, a sprained ankle takes about two weeks to heal unaided. However, several factors, including the classification of the ankle sprain can throw this recovery time off.
When you’ve experienced severe ankle injuries, consult our experts at Movement 101. Our professionals can put you on the right track by offering an honest assessment of your recovery time and how best to take care of the injured ankle. Visit https://www.movement101.com.au/waterloo.html for more information.

Movement 101 Waterloo
3/863 Bourke St
Waterloo NSW 2017​
02 7204 4159

Find us on Social Media
​https://www.facebook.com/Movement101.Physio
https://twitter.com/mvmt_101
https://www.linkedin.com/company/wolli-creek-physiotherapy-&-pilates/
https://www.youtube.com/channel/UCV3IfTrtE9sAwbHRdOTZJ8g
https://www.instagram.com/movement101.physio/