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Lateral Ankle Sprains
Most common sporting injury. Usually inversion and plantarflexion injury in activity involving sudden turn of direction.
Most significant predictor of ankle sprain is a previous sprain.
History: mechanism of injury; ‘Cracking’ sound at time of injury;
Physical examination: swelling; pain on palpation
Imaging: Stress x-ray
Classification System:
Grade 1 Minor tear with no laxity; minimal swelling and pain; joint is stable; full range of motion; can weight bear.
Grade 2 Some degree of laxity with firm end point; moderate pain and swelling; decreased range of motion; difficulty weightbearing
Grade 3 Gross laxity with no firm end point; sever pain and swelling; unstable joint; inability to bear weight
Initial Treatment:
RICE; avoidance of things that increase blood flow, such as alcohol, excessive weightbearing or heat; strapping to restrict range of motion; reduction of pain and inflammation; electrotherapeutic modalities. Soft tissue therapy and mobilisation after first 48 hrs
Grade 2 may need cast immobilisation for up to 3 weeks
Grade 3 may need surgical repair
Early mobilisation associated with better outcomes
Rehabilitation:
Strapping to protect ankle at commencement of weightbearing; stretching and strengthening exercises when pain allows; proprioception and balance exercises; progressing to jumping and hopping exercises; gradual return to sport.
(See Orthopaedics & Musculoskeletal chapter for Chronic pain following ankle sprain)
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