[WORLD] Ankle sprains are one of the most common musculoskeletal injuries, affecting both athletes and everyday individuals. While many consider them a minor inconvenience, recurring sprains can lead to chronic issues and even arthritis. Understanding why some people are more susceptible to these injuries and learning how to promote faster healing is crucial for maintaining long-term ankle health.
Factors That Increase Susceptibility to Ankle Sprains
Anatomical Predisposition
Some individuals are naturally more prone to ankle sprains due to their foot structure. Dr Nicholas Yeo, an orthopaedic surgeon at Mount Elizabeth Hospital, explains, "High-arched feet can make you more prone to sprains. This type of foot shape causes the ankle and foot to curve inwards slightly, and makes it more likely to invert or 'roll' the ankles inwards."
Ligament Laxity
Having naturally lax ligaments can increase the risk of ankle sprains. Adjunct Assistant Professor Andrew Hong Choon Chiet, head and consultant with NUH's Department of Orthopaedic Surgery, Division of Foot and Ankle Surgery, notes that individuals with more flexible joints may have a wider range of motion, which can be beneficial for activities like yoga but increases the risk of ankle sprains.
Previous Injuries
A history of ankle sprains significantly increases the likelihood of future injuries. Research shows that individuals who have previously sprained their ankle are up to twice as likely to experience another sprain. This increased risk is due to potential damage to the ankle's structural integrity and sensorimotor function, which can impair an individual's ability to avoid injurious situations.
Sports Participation
Certain sports inherently carry a higher risk of ankle sprains. Dr Yeo points out, "Basically, any sports where you have to jump, land and pivot quickly would predispose you to ankle injuries." Basketball, soccer, volleyball, and racket sports are particularly high-risk activities due to their dynamic nature and frequent changes in direction.
Age and Gender
Studies have shown that age and gender can play a role in ankle sprain susceptibility. Females over the age of 30 appear to have a higher risk of ankle sprains compared to males in the same age group. Conversely, in younger athletes (ages 15-24), males seem to have a higher incidence of ankle sprains.
The Importance of Proper Healing
Failing to allow an ankle sprain to heal properly can have serious long-term consequences. Adj Asst Prof Hong warns, "If adequate treatment is not instituted early, especially in more severe cases, trauma to the ankle's surrounding structures such as cartilage, bone, tendons and other ligaments can result."
Chronic ankle instability is a common outcome of repeated sprains or inadequately healed injuries. This condition can lead to ongoing pain, swelling, and a feeling that the ankle might "give way" during activity. Even more concerning is the potential development of ankle arthritis.
Dr Yeo explains the connection between sprains and arthritis: "Ankle sprains contribute to up to 22 per cent of all cases of ankle arthritis. Recurrent ankle sprains lead to ankle instability and this results in uneven weight distribution over the ankle joint. Over time, this can progress to ankle arthritis."
Strategies for Faster Healing and Prevention
Immediate RICE Protocol
The RICE method (Rest, Ice, Compression, Elevation) remains a cornerstone of initial ankle sprain treatment. Dr Yeo emphasizes the importance of early intervention: "It's crucial to apply ice to the injured area within 24 hours of the injury. A firm compressive dressing should be applied to help reduce swelling. The foot should be elevated above the heart to reduce swelling and a course of anti-inflammatory medication will aid in this, too."
Gradual Return to Activity
After the initial healing phase, it's crucial to gradually reintroduce movement and strength training. Dr Yeo recommends, "After approximately two weeks, when the swelling has subsided, the key is to restore the ankle's range of motion, strength and flexibility. Working with a physiotherapist to guide you through this phase of recovery is helpful. After about eight to 10 weeks, a gradual return to exercise and sports is possible."
Proprioceptive Training
Improving balance and proprioception (the body's ability to sense its position in space) is crucial for preventing future sprains. Exercises such as single-leg balance, using balance boards, and sport-specific drills can help retrain the ankle's neuromuscular system.
Proper Footwear and Support
Wearing appropriate footwear for your activity and foot type can significantly reduce the risk of ankle sprains. For those with a history of sprains, using ankle braces or taping during high-risk activities can provide additional support.
Strength and Flexibility Training
Strengthening the muscles around the ankle and improving overall lower limb flexibility can enhance stability and reduce the risk of injury. Focus on exercises that target the calf muscles, peroneal muscles (along the outer lower leg), and the muscles of the foot.
When to Seek Professional Help
While many ankle sprains can be managed at home, certain situations warrant professional medical attention. Dr Yeo advises, "If you continue to experience ankle pain and instability three months after a sprain, surgery may be required to reconstruct the ankle ligaments."
For cases of chronic ankle instability or developing arthritis, more advanced interventions may be necessary. Adj Asst Prof Hong explains, "In such an instance, the gold standard surgery is ankle fusion or arthrodesis, where the ankle joint is fused to eliminate motion. This is a time-proven and effective surgery to relieve pain and improve function."
Alternatively, total ankle replacement surgery (arthroplasty) is an option that allows for preserved range of motion. Dr Yeo, who claims to be the earliest surgeon in Asia to perform this procedure, states, "An ankle replacement procedure protects the adjacent joints around the ankle as opposed to a fusion procedure, which puts more stress on the surrounding joints."
Ankle sprains, while common, should not be taken lightly. Understanding your personal risk factors and taking proactive steps to prevent and properly heal these injuries is crucial for maintaining long-term ankle health and overall quality of life. By implementing proper healing strategies, engaging in preventive exercises, and seeking professional help when needed, you can significantly reduce your risk of chronic ankle issues and continue to enjoy an active lifestyle.
Remember, each ankle sprain increases the likelihood of future injuries, so treating even minor sprains with care and attention is essential. Whether you're an athlete or simply someone who enjoys staying active, prioritizing ankle health can help ensure you stay on your feet and moving comfortably for years to come.
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