Types Of Ankle Sprains

An ankle sprain is a stretching or tearing of the ankle ligaments, and usually the outside of the ankle.

It is one of the most frequent injuries, in sport up to 30% of footballers get to present a sprain at least once a year and we tend to give it little importance, but sprains not only occur while practicing a sport, but also , even walking at a slow speed or going down the stairs. Being one of the most common injuries, it is usually taken lightly, which often means that we do not treat it well. It must be taken into account that up to 20% of severe sprains are associated with another injury, therefore it is important to take it seriously and treat it properly from the start.

sprain mechanism

In a survey that we conducted with our patients at the Mediprax foot evaluation clinic when they attended the baropodometric study process to design their orthopedic insoles , it was indicated that at least once in their lives they have suffered a sprain and this does not receive the proper treatment.

The ligaments that hold and give stability to the ankle are 3, these are located on the outside, which form a triangle, and one on the inside, thicker and triangular in shape, which is the deltoid ligament.

Although everyone can suffer a sprain , the vast majority will occur on the outside as a result of twisting the ankle inwards. The most frequently affected ligament is the external lateral (16-21% of traumatic sports injuries), more specifically the anterior talofibular fascicle, which is the one that frequently breaks.

Depending on the lesion pattern, the calcaneal fibular ligament is affected and if force does not stop it, it ends up injuring the posterior talofibular ligament.Injuries to the internal lateral ligament or deltoid complex rarely occur in isolation, accompanied by bone injuries. The so-called high ankle sprain affects the lower tibiofibular ligaments. In the ankle, osteochondral lesions up to 7% associated with ligamentous damage are not uncommon.


The static stability of the ankle depends on the integrity and functionality of the distal ligamentous complexes, linked together by the syndesmosis (it is a fibrous joint that joins bones separated by a wide distance with a sheet of fibrous tissue, either a ligament or a membrane). fibrosa ) tibiofibular. The ligaments are strengthened by muscular action, the lateral ligament by the peroneal and the medial by the tibialis posterior.

  • Tibiofibular syndesmosis, joint stabilized by the anterior, posterior, interosseous and transverse tibiofibular ligaments.
  • Medial, tibial or deltoid ligament: It is arranged like a fan in 2 planes, superficial and deep, from the tibial malleolus to the scaphoid, talus and calcaneus. The deep fasciculus is the main medial stabilizer. If it ruptures, the talus tends to valgus.
  • Lateral peroneal ligament.

A poorly treated sprain can cause the ligaments to not heal properly and the ankle becomes unstable or loosely supported. In this case, the energy required to suffer a new sprain is less and less and the ankle sprains or fails repetitively; what we call chronic instability.

Ankle sprain caused by ankle instability.

It must be taken into account that the ankle receives enormous loads in day-to-day activities, especially in sports with twisting on the leg. In unstable ankles, each failure or new sprain can cause damage to the cartilage of the talus or even cause fractures in the fibula and tibia. In addition, it is one of the joints that is most quickly destroyed when it does not function correctly, either due to chronic instability or due to cartilage injury, usually after trauma.

Classification of sprains by their degree of injury:

The first degree is a slight stretching of the ligaments, where inflammation may be present, pain when placing the foot. At this grade it is important to start gradual support and strengthening as soon as possible.

In the second degree, the distension can affect some ligament fibers among other tissues, which will favor the presence of a hematoma (it is a mark on the skin caused by the presence of blood trapped below the surface of the skin. It occurs when an injury breaks small blood vessels, but does not break the skin These vessels open up and let blood escape under the skin, swelling and pain The pain is usually so great that walking is impossible and even a condition has to be ruled out fracture; rehabilitation must be immediate in order to obtain the necessary care.

It is the most serious type of sprain of the three, and it occurs when there is a total tear of the ligament. This type of sprain causes a lot of pain and the area swells considerably. We will have the sensation that the ankle is lax, without strength and it will be impossible to support the foot on the ground.

Grade 3 sprains require full joint immobilization and the use of crutches. The recovery time for this type of sprain lasts up to 3 months, and can be much longer if we do not make a correct recovery.

After sprains, the patient’s gait must be verified to avoid weight overload in certain parts of the sole of the foot , this can be done through the baropodometric study and, if necessary, the design of orthopedic insoles .


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