Rolling an ankle may not always be as simple as it seems.
With competitive sports returning back to normal this year, unfortunately so have the injuries.
One of the most common sporting related injuries we see as podiatrists are lateral ankle sprains. According to a recent research article, lateral ankle sprains make up up to 40% of all sporting related injuries. Of these lateral ankle injuries, 65% of the cases are isolated Anterior Talofibular Ligament sprains or tears. Although highly probable your lateral ankle sprain has involved the anterior talofibular ligament, we are seeing an increased rate of even more going on within the same anatomical region.
Two recent patients of mine demonstrates the importance of a thorough assessment of ankle injuries, regardless of how ‘obvious’ it may seem.
Case Study 1
Patient A presented to me with ongoing lateral ankle swelling and close to severe pain 2 weeks following the ankle sprain. This patient has high arches and a rigid foot, which has unfortunately meant he has had multiple rolled ankles in his life, but never has the pain and swelling last this long and to this extent.
Patient A wanted to get my opinion on what else he could be doing to assist in the recovery of his rolled ankle, and after a quick assessment I suspected that there was more going on and advised him to wear a moon boot whilst weight bearing until we got the results from the X-ray. After an X-ray, a Weber A fracture of the distal fibula was found. This obviously changed the trajectory of this patient’s recovery timeline and required more extensive treatment.
Case Study 2
Patient B had a traumatic ankle injury whilst playing football and was immediately taken to hospital where they performed an X-ray and quickly discovered a Weber B fracture of the distal fibula. This patient was placed in a cast initially and advised to transition to a moon boot for a period of 6 weeks following this.
This patient initially presented to our clinic after transitioning out of the moon boot as her ankle wasn’t feeling right.
After a referral to get an ultrasound on the ankle, a grade 2 tear of the anterior inferior tibiofibular ligament (syndesmotic injury) was found. Following this, the patient required further time in a moon boot, more advanced exercise rehabilitation and definitely more time away from sport.
If you’re ever unsure about an injury, please see your podiatrist. It may not always be as simple as it seems.