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Ankle Sprains in Football

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Introduction

Ankle sprains are one of the most common injuries among football players, and they can occur in various forms depending on the mechanism of injury and affected ligaments. In this blog, we’ll explore the different types of ankle sprains seen in football, including lateral, medial, and high ankle sprains. We’ll also discuss the symptoms, assessment, and rehabilitation techniques for each type, helping football players understand what to expect when dealing with these injuries.

Types of Ankle Sprain

  • Lateral (Inversion) Ankle Sprains: Lateral ankle sprains are the most prevalent type of ankle injury in football. They typically occur when the foot rolls inward, causing damage to the ligaments on the outer side of the ankle. Symptoms may include pain, swelling, and difficulty bearing weight on the affected foot.
  • Medial (Eversion) Ankle Sprains: Medial ankle sprains are less common but still significant injuries in football. These occur when the foot turns outward, leading to strain or tearing of the ligaments on the inner side of the ankle. Football players with medial ankle sprains may experience tenderness and instability.
  • High Ankle Sprains: High ankle sprains, also known as syndesmotic sprains, involve the ligaments connecting the two bones of the lower leg (tibia and fibula). These injuries often occur from excessive external rotation or twisting of the ankle. High ankle sprains can be particularly challenging to recover from, requiring more extended rehabilitation periods.

Ankle Sprain Symptoms

Symptoms of ankle sprains can vary depending on the severity of the injury. Common signs include:

  • Pain: Ankle sprains often cause localised pain around the injured area, which can range from mild discomfort to severe pain.
  • Swelling: The injured ankle may become swollen due to inflammation and fluid build up in the affected tissues.
  • Bruising: Some individuals may develop bruising around the ankle joint, especially in more severe cases.
  • Tenderness: The ankle may feel tender to touch, and pressure on the injured area can elicit pain.
  • Instability: In more severe sprains, the ligaments may become significantly stretched or torn, leading to a feeling of instability or “giving way” of the ankle.
  • Difficulty Weight-Bearing: Walking or putting weight on the affected foot may be challenging and painful.
  • Limited Range of Motion: Ankle mobility may be reduced, and the injured individual may have difficulty moving the foot in certain directions.

Assessment and Diagnosis

Accurate assessment of ankle sprains is crucial for determining the severity of the injury and developing an appropriate treatment plan. The assessment may involve the following:

  • Medical history: Gathering information about the player’s symptoms, mechanism of injury, previous ankle injuries, and any relevant medical conditions.
  • Physical examination: The football physiotherapist will evaluate the ankle for tenderness, swelling, range of motion, stability, and specific signs of ligamentous injury.
  • Special tests: Specific tests, such as the anterior drawer test or talar tilt test, may be performed to assess the stability and integrity of the ankle ligaments.
  • Ottawa ankle rules: If there is tenderness on specific bony structures such as the medial or lateral malleolus (bony bit of the inner / outer ankle) or an inability to weight-bear for four steps or more, an x-ray may be required to check for an avulsion fracture.  
  • Imaging: Depending on the severity of the injury, further investigation may be needed such as x-ray or MRI imaging.

Treatment Options

The management of ankle sprains may include:

  • RICE (Rest, Ice, Compression, Elevation): Immediate treatment to reduce pain, swelling, and inflammation.
  • Immobilisation: Depending on the severity of the sprain, a walking boot, or ankle taping may be used to provide support and immobilise the ankle during the initial healing phase.
  • Early mobilisation: Gradually reintroducing range of motion exercises and weight-bearing activities as pain and swelling decrease.
  • Physiotherapy: A structured rehabilitation program involving various exercises to restore ankle strength, flexibility, proprioception, and balance.
  • Functional exercises: Incorporating sport-specific movements and activities to prepare the player for a safe return to football.
  • Surgery: In severe ankle sprains, or cases that do not respond to conservative treatment, surgical intervention may be required.

Products that may help

Anti-inflammatory patch – Available here

The Nurofen Joint and Muscular pain relief plasters continuously releases ibuprofen over 24 hours to target pain and inflammation at the site of pain. This can be an effective option for reducing the initial swelling from the ankle sprain injury.

Ankle Cool Sleeve Ice Pack – Available here

This ankle ice pack provides cold therapy and compression for the entire ankle area, providing pain relief and helping to reduce swelling. The ice pack contains gel to ensure longer lasting cold therapy and the ankle specific design also provides compression to the injured area.

Balance Cushion – Available here

The balance cushion is a useful piece of equipment to provide challenging proprioception exercises that help to improve stability of the ankle.

Ankle Support – Available here

The aim of ankle sprain rehabilitation is to regain full function of the ankle and hopefully return to training and games without needing an ankle strapping. However, in the initial stages after an ankle sprain, or cases of chronic instability, an ankle strapping is often required. This ankle support is a high quality option for football players.

Rehabilitation Techniques

Rehabilitation is essential for a safe return to football after an ankle sprain. A tailored program may include:

  • Range of Motion Exercises: Gentle movements to restore the ankle’s full range of motion.
  • Balance and Proprioception Training: Exercises to improve joint stability and prevent re-injury.
  • Strengthening Exercises: Focused on building muscle strength around the ankle joint.
  • Sport-Specific Activities: Gradual integration of football-specific drills into the rehabilitation program.

Conclusion

Ankle sprains are common injuries in football, and the type of sprain will determine the treatment and rehabilitation approach. Lateral, medial, and high ankle sprains require proper assessment, treatment, and rehabilitation to ensure a safe return to the pitch. Consulting with a football physiotherapist or healthcare professional is crucial for an accurate diagnosis and comprehensive recovery plan. By following appropriate treatment and rehabilitation strategies, football players can minimise the risk of re-injury and enjoy playing the game with confidence.

Further Reading

Nery et al, (2016) – Foot and ankle injuries in professional soccer players: diagnosis, treatment, and expectations

Chen et al, (2019) – Ankle sprains: evaluation, rehabilitation, and prevention

Ortega-Avila et al, (2020) – Conservative treatment for acute ankle sprain: a systematic review

Disclaimer

The information provided in this article is for educational purposes only and should not substitute professional medical advice. Always consult with a qualified healthcare professional for diagnosis, treatment, and personalised recommendations based on your specific condition. Some affiliate links may also be used in this article, these are from products we have specifically selected to display based on our own experience.

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