The ankle is a hinged joint capable of moving the foot in two primary directions; away from the body (plantar flexion) and toward the body (dorsiflexion). The ankle is formed by three bones; the large dome shaped bone at the top of the foot (talus), the end of the shin bone of the leg (tibia) and a small bone in the leg (fibula). As well as walking between 5000-10,000 steps a day, many of us carryout other physical activity such as running, aerobics, squash and tennis. Add this to the fact that our feet and ankles have to absorb our own body weight they are very vulnerable to injury.

The ankles complexity comes from the ligaments that support it and the angle at which it should sit. The hard bony nodules on each side of the ankle provide stability as the ankle must withstand our bodyweight during standing and walking.

There are ligaments on each side of the ankle which provide stability, hold the bones in position and protect it from abnormal movements. There are tendons attaching the muscles of the leg to the foot and these wrap around the ankle both from the front and back. The Achilles tendon, the large tendon of the calf muscle passes behind the ankle and attaches at the back of the heel.

Ankle sprains are one of the most common musculoskeletal injuries in the body.

They can happen to both the athlete and the non-athlete alike. Ankle sprains occur as a result of sudden over stretching of the ligaments beyond their normal length. If the force is too strong the ligaments can completely tear.

The typical ankle sprain can simply occur when we step off an uneven surface or when taking part in physical or sports activity. Initially there is severe pain and sometimes an associated “popping” sensation. There is an immediate inflammation leading to pain and swelling over the area due to injured blood vessels leaking fluid into the local tissue.

Ligament injuries are graded 1-3

• Grade 1: A mild sprain
• Grade 2: A moderate sprain
• Grade 3: A severe strain (complete tear).

Ankle sprains frequently occur when there is a preexisting muscle weakness in the ankle or a history of previous ankle injuries.

If the ankle pain is so severe or persistent you may need to have X-rays to make sure you have not broken any bones in the ankle or foot. Sometimes it is hard to tell whether you have broken bones or a bad sprain as both can have similar symptoms of pain and swelling.

After the initial injury if there is a complete tear of a ligament or a complete dislocation of the ankle joint the ankle may become unstable. If this occurs it is possible that the injury may also cause damage to the ankle joint surface itself.

Most ankle sprains need a period of 6 weeks to 12 weeks for healing. It is important to incorporate motion into the healing process early to prevent stiffness but not until the initial inflammation has eased which usually takes 7-10 days. Motion can also aid in the healing process by stimulating proprioception. This is important for location, sense of position and movement of the ankle joint so as not to develop weakness and long term problems.

Inflammation of the tendons (tendonitis) is also a common injury to the ankle area. The condition is commonly associated with trauma. The Achilles tendon can often rupture in those who continue athletic activity when they have an inflamed tendon or in those who have had previous Achilles tendonitis.

Rehabilitation after a sprain takes time and attention to restore the optimal strength and range of movement so you can return to pre-injury level. The time that you can expect to spend recovering depends on the amount of damage that was done and what structures were involved. Chiropractic treatment can help restore and maintain normal flexibility of the foot and ankle joints and soft tissue work will help to prevent scar tissue. Your chiropractor may also recommend exercises to maintain movement and balance exercises to help stimulate all the small nerves in the foot helping you to reduce the chances of long term damage.

Many other factors play a significant role in ankle pain these include flat feet, abnormal bone alignment, walking and running style and type of shoe. These factors also play a significant role in the health of your back, legs and knees.  

Those who have broken or injured their ankle and have had to limp or use crutches know that it can affect the rest of the body. The effects are not only seen in the foot and ankle but the knee, hip, spine and even shoulders. It is important that you visit a chiropractor so that they can examine your ankle but also examine the rest of the body so that you do not develop long standing problems.