Ankle injuries are perhaps one of the most common injuries in the world of Sports. From amateurs to pro-players, ankle injuries have been a serious potential problem to anyone playing a sport. Although most ankle injuries are minor and can heal within a few weeks, some ankle injuries can be permanent, and for pro-players, even career ending. Hence, it is important to know how to prevent such injuries, types of ankle injuries, as well as the remedies required when such injury happens.

Anatomy of the Ankle

To understand ankle injuries, we first have to understand the ankle itself. The ankle joint is made up of 3 bones: the ankle bone and the ends of the two lower leg bones. These bones are supported by ligaments, which are moved by muscles and tendons.

Anatomy of the ankle
Image 2.1: Anatomy of the ankle Source: http://elitefootandanklecenter.com/patient-education/anatomy-of-the-foot-and-ankle/

Types of Ankle Injuries

Ankle injuries can be classified into sprains and fractures.

Sprains

Sprains refers to injuries sustained on the ligaments. Sprains usually occurs when the ligaments supporting the ankle become overstretched beyond the functional range. This is usually the consequence of the foot turning or rolling in a bad angle as a result of falling, landing wrongly or a collision. It can also be due to the use of shoes that are not of the right size or shape, and when walking on uneven surfaces. Ankle sprains comes in the form of an inversion, eversion or high ankle sprain.  Ankle sprains usually takes weeks to months to recover completely, depending on how seriously the ligament is stretched or torn.

Types of ankle sprains
Image 3.1: Types of ankle sprains Source: https://www.fastmed.com/health-resources/do-i-have-a-sprained-ankle/

Fracture

Ankle fracture is when one or multiple bones that make up the ankle get broken. It can happen when the ankle is twisted or rolled, usually in circumstances that involved impact on the ankle. This includes running, jumping, falling and tripping. An ankle fracture can also begin as a ligament tear, but worsens should the ligament pull a piece of bone along with it. This is known as an avulsion fracture.

A fractured ankle shares similar symptoms to a sprained ankle, including severe pain, swelling or bruising. Hence, it can be very hard to differentiate between the two.

X-ray image of fractured ankle
Image 3.2: X-ray image of fractured ankle Source: https://orthoinfo.aaos.org/en/diseases–conditions/ankle-fractures-broken-ankle/

How to tell the difference between a sprain and a fracture

In general, if there is pain around the soft tissue areas, but not around or on the bone, it probably is a sprain. However, if there is pain on the bone of the ankle, and you are not able to walk, there might be a fracture. You can try standing and putting weight on your injured leg, followed by walking to test the intensity of the pain, and if you are able to walk.  If you are able to walk without much difficulty and pain, you most likely only sprained your ankle

A sprain usually also happens without any sound, or with a popping sound in more severe cases. For fractures, there usually will be a cracking sound.

Swelling is a symptom found in both sprains and fractures. However, if your ankle looks out of place, there is a higher chance that you have a fractured ankle.

Fractured ankle that looks out of shape
Image 4.1: Fractured ankle that looks out of shape Source: https://forums.mtbr.com/rider-down-injuries-recovery/ankle-fracture-pilon-fracture-947060.html

During a sprain, there will be painful sensation. However, if you have fractured your ankle, you may not feel the pain, but instead numbness or a tingling sensation.

Types of Treatment & Prevention

Written by: Lim Jun Tian

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