Liam Warner is a 24-year-old male who is dropped off at the urgent care clinic with right ankle pain and swelling. This morning Liam was running in a 10K run when his foot landed on an uneven surface, injuring his ankle. He says “My foot didn’t land right and I could feel it rolling inward. I wasn’t able to finish because I could barely walk.” While in the clinic, an ankle X-ray series rules out a bone fracture, and a grade 2 sprain is suspected.
Local musculoskeletal injuries mainly include conditions that affect bones, joints, muscles, and ligaments. The most common ones include bone fractures; joint dislocations; muscle or tendon strains; and finally, ligament sprains. Now, sprains typically occur when the physical force applied to the joint exceeds the elasticity of the surrounding ligaments. And this is particularly common in ankle injuries, when there’s incorrect positioning of the foot at landing, like when a person is walking or running on an uneven surface; or they fall and twist their ankle; another frequent scenario involves jumping and awkwardly landing on their foot; or being stepped on during a sports game.
Now, there are two main types of ankle sprains. Lateral sprains are the most common ones and they are typically caused by forced inversion of the foot. In other words, a person’s sole rotates inwards or medially, but too much, eventually damaging the ligaments located on the outer side of the joint. On the other hand, medial sprains are caused by forced eversion of the foot, meaning a sole rotates outwards or laterally, eventually damaging the medial ligaments.
Alright, there are some factors that can put a person at risk for ankle sprains. Modifiable risk factors include wearing inappropriate footwear, having poor athletic condition, not warming up before training, and fatigue from overtraining or intense physical activity. On the other hand, non-modifiable risk factors include being male between the ages of 15 to 24, or being female over the age of 30, as well as previous history of ankle sprains; balance problems; and conditions associated with foot misalignment, such as pes cavovarus, often referred to as overarched foot.
