Ankle sprains

Ankle sprains are common in daily life. Sprain usually occurs when the foot turns inwards due to the excessive range of motion in that direction. As the foot turns inside, the ligaments on the outside of the foot are stretched and sometimes break.
There are very strong ties on the inside and outside of the foot. All these ties have 2 main functions. One of them is to connect the two bones as it is called and distribute the load on the joint in a way to conserve energy during the movement. The other task is propioception: there are sensor cells in the structure of the ligaments and they constantly talk about the positional state of the ligament with the central nervous system. If this propioception does not come back after injury to a ligament, the brain cannot understand the position of the joint in rapid movements and sprains occur again because the muscles cannot make reflex movements. It is very important to do these propioception movements besides strengthening exercises after sprains.
The ankle is not one ligament on the outer side. In fact, it is a harmonically working link complex. The anterolateral talofibular ligament is the most commonly injured ligament.

We classify ligament injuries according to the anatomical severity of the sprain:
Grade 1: (Slight) ligament stretched slightly, no visible tears.
2nd degree: (Moderate) There is a partial tear in the vineyard.
Grade 3: (Heavy) The ligament and even the joint capsule were ruptured.

A functional classification is also made:
1st degree: The ankle feels solid, the patient can walk with a little pain.
2nd degree: Ankle feels solid from time to time. there is obvious pain when walking.
3rd degree: The ankle does not feel firm at all while walking, there is a limp; It is difficult to walk because there is space in the ankle.

There is another type of sprain that we call high ankle sprain. The structure that is injured here is not the ankle ligament, but the intermediate ligament connecting the tibia and fibula.

 

When there is a sprain, it should not be removed from the ground immediately, but should be moved after finding a safe support. A compressive bandage should be applied for the first 48 hours and the leg should be kept elevated to reduce edema and early recovery. Cold application 3-5 times a day may be good.
In the following days, either plaster boots or ankle support splints are used, depending on the degree of injury.

RICE- rest, ice, compression, elevation (rest, cold application, bandage, holding up) treatment is performed.

In order to find out the degree of ligament injury, MRI examination should be done after 3 weeks, and if there is no complete rupture, strengthening and propioception exercises should be started immediately. Depending on the condition of the ligament in complete ruptures, the ligament can be sutured by arthroscopic method or open reconstruction surgery can be performed if it is very damaged.