Common Ankle Injuries
Your ankle muscles and tendons dynamically control, move and protect your ankle joint. In simple terms, your muscles move your foot and stabilise your ankle joint to avoid you overstretching your ligaments. Unfortunately, when your muscles lose control or are not quick enough, your ligaments are not protected, resulting in overstretched ligaments (ankle sprain) or complete ligament rupture. Ouch, that hurts!
However, there are many other types of ankle injuries besides a sprained ankle, and we categorise them by the kind of tissue injured, e.g. bone (fracture), ligament (sprained ankle), muscle (strain or tear), or tendon (tendinopathy or tendonitis).
Ankle pain can arise from traumatic ankle ligament sprains or ankle fractures (broken bones). Plus, ankle pain can be more subtle in origin. Tendinopathies, degenerative arthritis and biomechanical disorders can develop ankle pain over time.
There are a lot of ankle injuries – not just sprained ankles. It is essential to accurately diagnose what is wrong with your ankle to ensure that both your short and long-term treatment achieve your goals as soon as possible.
Your Ankle Ligaments
Your ankle joint, which is known as the talocrural joint, is made up of three bones. Your tibia (shin bone; inside ankle bone), fibula (outer lower leg bone; outside ankle bone), and your talus (deep ankle bone). Beneath your talocrural joint lies the subtalar joint, articulating the talus and the calcaneus (heel bone). This forgotten joint is overlooked frequently during assessment, diagnosis and rehabilitation.
Your ankle ligaments attach bone-to-bone. They passively limit the motion available at each joint.
Outside of the ankle are the lateral ligaments. These ligaments are the most frequently injured in a lower ankle sprain. These include the:
- anterior talofibular ligament (ATFL)
- calcaneofibular ligament (CFL)
- posterior talofibular ligament (PTFL)
The main medial (inside of the ankle) ligament is the much stronger deltoid ligament.
High ankle sprains involve the inferior tibiofibular ligament and syndesmosis. These are more disabling ankle injuries. Unfortunately, misdiagnosis is common.
For specific advice regarding your ankle injury, please visit one of the particular ankle injury information pages on this website, or arrange a consultation with one of our ankle physiotherapists.
Common Ankle Injuries
The most common ankle injury is a sprained ankle, but ankle pain can have numerous sources.
Ankle pain that results from a traumatic injury is often a sports-related injury. But you don't necessarily have to be an athlete or even a social sportsperson to twist your ankle.
Something as simple as walking on an uneven footpath can cause a rolled ankle, resulting in an ankle sprain. Ankle injuries can potentially occur at any age. Thousands of people sprain their ankle every day around the world. Just while you've been reading this article, a few hundred people have sprained their ankle. While ankle pain can result from many ankle and foot injuries, the most common ankle injuries are sprains (low and high ankle), which involve ligaments and bones in the ankle. But you can also fracture a bone, tear muscles or over-stress a tendon when you sprain your ankle.
High ankle sprains are generally a more significant injury. These injuries require thorough assessment and treatment to avoid long-term ankle arthritis. If you can't perform a single-leg calf raise within a few days, please seek an early professional ankle assessment.
An ankle fracture occurs when there is a break in one or more of the bones. The most common ankle fractures are avulsion fractures of your distal fibula, which can be a side effect of an ankle sprain. These are generally less troublesome than if you experience a talar dome fracture with your actual ankle joint. Potts fracture is a significant fracture of your tibia and fibula simultaneously. All suspected fractures require medical investigation and professional management by your health professional to avoid long-term foot and ankle issues. If your healthcare professional suspects an ankle fracture, you will be referred for at least an X-ray and potentially an Orthopaedic Surgeon. Related links:
- Ankle Fracture (Broken Ankle)
- Stress Fracture
- Stress Fracture Feet
- Severs Disease
- Heel Spur
- Shin Splints
While muscle strains are more common in your legs, there are essential muscles that converge into tendons that wrap around your ankle to stabilise your ankle and foot to protect them from sprains and allow you to walk and run. These muscles and their tendon vitally provide you with a normal foot arch and avoid flat feet.
Your muscles or tendons can become injured or inflamed as a result of overuse or trauma. The inflammation is called tendonitis. They can also tear, completely rupture, or sublux out of place. Medically tendon injuries are known as tendinopathies, and at the ankle may include:
- Achilles Tendinopathy
- Achilles Tendon Rupture
- Peroneal Tendinopathy
- Tibialis Posterior Tendinopathy
- FHL Tendinopathy
- Plantar Fasciitis
Your ankle pain and dysfunction can lead to degenerative conditions such as ankle osteoarthritis. While arthritis usually is a chronic deterioration of your ankle joint, it is crucial to slow ankle arthritis progression. Please seek the professional advice of your ankle and foot health practitioner, e.g. physiotherapist or podiatrist.
Biomechanical disorders may result in foot deformation, painful weight-bearing and potentially nerve compression. In simple terms, this is where your foot and ankle do not have normal bone alignment and motion contr. Here are a few possible conditions related to poor ankle biomechanics.
- Anterior Ankle Impingement (Front of Ankle Pain)
- Posterior Ankle Impingement (Back of Ankle Pain)
- Pes Planus (Flat Feet)
- Tarsal Tunnel Syndrome
Nerve-Related Ankle Pain
Children & Youth Conditions
Systemic Conditions that may cause Ankle Pain
Soft Tissue Inflammation
Other Useful Information
Common Stress Fracture Related Conditions
Spinal Stress Fractures
- Spondylolysis (Back Stress Fracture)
- Lumbar Stress Fractures (Cricket Fast Bowlers)
- Rib Stress Fracture
Lower Limb Stress Injuries
Sports Injury Management
You probably already know that a sports injury can affect not only your performance but also your lifestyle. The latest research continues to change sports injury management considerably. Our challenge is to keep up to date with the latest research and put them to work for you.
How we treated you last year could vary significantly to how we treat you this year. The good news is that you can benefit considerably from our knowledge.
What Should You Do When You Suffer a Sports Injury?
Rest from painful exercise or a movement is essential in the early injury stage. "No pain. No gain." does not apply in most cases. The rule of thumb is - don't do anything that reproduces your pain for the initial two or three days. After that, you need to get it moving, or other problems will develop.
Ice or Heat?
We usually recommend avoiding heat (and heat rubs) in the first 48 hours of injury. The heat encourages bleeding, which could be detrimental if used too early. In traumatic injuries, such as ligament sprains, muscle tears or bruising, ice should help reduce your pain and swelling.
Once the "heat" has come out of your injury, you can use heat packs. We recommend 20-minute applications a few times a day to increase the blood flow and hasten your healing rate. The heat will also help your muscles relax and ease your pain. If you're not sure what to do, please call us to discuss your situation specifically.
Should You Use a Compressive Bandage?
Yes. A compressive bandage will help to control swelling and bleeding in the first few days. In most cases, the compressive dressing will also help support the injury as you lay down the new scar tissue. This early healing should help to reduce your pain. Some injuries will benefit from more rigid support such as a brace or strapping tape. Please ask us if you are uncertain about what to do next.
Gravity will encourage swelling to settle at the lowest point. Elevation of an injury in the first few days is beneficial, especially for ankle or hand injuries. Think where your damage is and where your heart is. Try to rest your injury above your heart.
What Medication Should You Use?
Your Doctor or Pharmacist may recommend pain killers or an anti-inflammatory drug. It is best to seek their professional advice as certain medications can interfere with other health conditions, especially asthmatics.
When Should You Commence Physio?
In most cases, "the early bird gets the worm". Researchers have found that the intervention of physiotherapy treatment within a few days has many benefits. These include:
- Relieving your pain quicker via joint mobility techniques, massage and electrotherapy
- Improving your scar tissue using techniques to guide the direction it forms
- Getting you back to sport or work quicker through faster healing rates
- Loosening or strengthening of your injured region with individually prescribed exercises
- Improving your performance when you return to sport - we'll detect and help you correct any biomechanical faults that may affect your technique or predispose you to injury.
What If You Do Nothing?
Research tells us that injuries left untreated take longer to heal and have lingering pain. They are also more likely to recur and leave you with either joint stiffness or muscle weakness. It's important to remember that symptoms lasting longer than three months become habitual and are much harder to solve. The sooner you get on top of your symptoms, the better your outcome.
What About Arthritis?
Previously injured joints can prematurely become arthritic through neglect. Generally, there are four main reasons why you develop arthritis:
- An inappropriately treated previous injury (e.g. old joint or ligament sprains)
- Poor joint positioning (biomechanical faults)
- Stiff joints (lack of movement diminishes joint nutrition)
- Loose joints (excessive sloppiness causes joint damage through poor control)
What About Your Return to Sport?
Your physiotherapist will guide you safely back to the level of sport at which you wish to participate. If you need guidance, ask us.
What If You Need Surgery or X-rays?
Not only will your physio diagnose your sports injury and give you the "peace of mind" associated, but they'll also refer you elsewhere if that's what's best for you. Think about it. You could be suffering needlessly from a sports injury. Please use our advice to guide you out of pain quicker. And for a lot longer.
If you have any questions regarding your sports injury (or any other condition), please contact your physiotherapist to discuss. You'll find our friendly staff happy to point you in the right direction.
Acute Sports Injury Clinic
How to Best Care for Your Sports Injury?
There is never an excellent time for an injury. But we do know that most sports injuries occur over the weekend! That's why at PhysioWorks, we have established an Acute Sports Injury Clinic at a selection of our clinics on a Monday and Tuesday.
The acute sports injury consultation fee is significantly lower than a routine assessment and treatment consultation. In most cases, your private health will cover the full cost of your full acute injury physio assessment fee.
Why Use an Acute Sports Injury Clinic?
Your Acute Sports Injury Assessment Consultation allows us to provide you with:
- A quick and accurate diagnosis. One of our Sports Physiotherapist's or an experienced sports injury-focused Physiotherapist will confidently guide your new injury management.
- Early acute sports injury care, professional advice and education. What to do this week?
- Fast referral for X-rays, ultrasound or MRI scans to confirm your diagnosis.
- Prompt referral to Sports Physicians, GPs or Surgeons with whom we work if required.
- Immediate supply of walking boots, braces and rental crutches if needed.
- Low-cost professional service.
For more friendly advice or guidance, please call your nearest clinic to discuss your specific needs.
Why Should You Enjoy the PhysioWorks Difference?
Friendly & Caring Service
One thing that you'll notice about the PhysioWorks team is that they are very friendly and caring health professionals. We know that sometimes pain or injury can make you a little less tolerant, so we've trained our healthcare team always to greet and treat you like they would a family member or best friend.
Thorough & Unrushed
Everyone should be entitled to individualised professional care. That's why we book longer initial appointments to ensure that your unhurried first visit will include a thorough and individualised assessment of your injury or problem. This extra time allows us to discuss your short, medium and long-term goals and treatment options before commencing your rehabilitation.
You'll find that your PhysioWorks healthcare practitioner is not only a great listener but also an excellent treatment planner to focus on your efficient and effective treatment outcome. After all, that's why you have chosen to see us in the first place.
What is the Aim of Your Initial Consultation?
Because we do spend more time than most physiotherapists thoroughly assessing, by the completion of your initial consultation, we should be able to determine and inform you:
- What exactly is your problem
- Why you are experiencing pain or dysfunction etc
- What you can be doing to correct it
- How long it will most likely take to recover
- How to prevent a future recurrence
Your Tailored Treatment Plan
Your physiotherapist will design a specific treatment program specifically for you based upon your examination. Your treatment may include hands-on treatment, such as joint manipulation, mobilisation or massage. It will probably also include lots of helpful advice and home exercises. We'll also use other technology or treatment tools depending upon your needs.
Your treatment will vary depending upon your age, sex, sport, work requirements or lifestyle, so generic therapies tend to be effective than specifically targeted treatment plans.
As highly-trained exercise prescribers, your physiotherapist will usually instruct you on specific exercises and stretches to undertake at home to assist in your rapid recovery. We'll also offer you helpful advice to help ease your pain, such as the appropriate resting positions or whether to use heat or ice and precisely for how long.
The result is prompt pain reduction, quicker natural healing and your successful return to full activity, whether it be work or sport, as soon as possible.
How Long is Your Physiotherapy Appointment?
Allow at least one hour for your initial physiotherapy session. Subsequent treatments are usually 30 to 60 minutes in duration. Your physiotherapist will inform you if additional or less time is required. Complex or multiple regions may require a longer consultation. Our receptionist will happily book an appropriate appointment for your clinical needs.
Do You Need a Referral to Consult a Physiotherapist?
A doctor's referral is not required to see a physiotherapist in private practice unless you claim a work injury (e.g. Workcover), or some other insurance claims. Department of Veterans Affairs patients will require a doctor referral. If you have been involved in a motor vehicle accident or plan for your treatment to be funded by an insurance company, it is good practice to consult your GP for a referral.
What About Private Health Insurance?
A proportion of treatment costs is rebatable under all higher table private health insurance schemes. The private health insurance rebates do vary considerably depending upon your specific coverage.
What is HICAPS?
PhysioWorks is linked to the HICAPS electronic health fund system so you can instantly claim your rebate at the time of treatment. You'll need to present your health insurance card to our receptionist.
Acute Injury SignsAcute Injury Management. Here are some warning signs that you have an injury. While some injuries are immediately evident, others can creep up slowly and progressively get worse. If you don't pay attention to both types of injuries, chronic problems can develop. For detailed information on specific injuries, check out the injury by body part section.
Don't Ignore these Injury Warning Signs
Joint PainJoint pain, particularly in the joints of the knee, ankle, elbow and wrist, should never be ignored. Because these joints are not covered by muscle, pain here is rarely of muscular origin. Joint pain that lasts more than 48 hours requires a professional diagnosis.
TendernessIf you can elicit pain at a specific point in a bone, muscle or joint, by pressing your finger into it, you may have a significant injury. If the same spot on the other side of the body does not produce the same pain, you should probably see your health professional.
SwellingNearly all sports or musculoskeletal injuries cause swelling. Swelling is usually quite obvious and can be seen, but occasionally you may just feel as though something is swollen or "full" even though it looks normal. Swelling usually goes along with pain, redness and heat.
Reduced Range of MotionIf the swelling isn't obvious, you can usually find it by checking for a reduced range of motion in a joint. If there is significant swelling within a joint, you will lose range of motion. Compare one side of the body with the other to identify major differences. If there are any, you probably have an injury that needs attention.
WeaknessCompare sides for weakness by performing the same task. One way to tell is to lift the same weight with the right and left side and look at the result. Or try to place body weight on one leg and then the other. A difference in your ability to support your weight is another suggestion of an injury that requires attention.
Immediate Injury Treatment: Step-by-Step Guidelines
- Stop the activity immediately.
- Wrap the injured part in a compression bandage.
- Apply ice to the injured part (use a bag of crushed ice or a bag of frozen vegetables).
- Elevate the injured part to reduce swelling.
- Consult your health practitioner for a proper diagnosis of any serious injury.
- Rehabilitate your injury under professional guidance.
- Seek a second opinion if you are not improving.
Acute Injury Treatments
- Early Injury Treatment
- Acupuncture and Dry Needling
- Gait Analysis
- Biomechanical Analysis
- Proprioception & Balance Exercises
- Real Time Ultrasound Physiotherapy
- Soft Tissue Massage
- Dry Needling
- Electrotherapy & Local Modalities
- Heat Packs
- Joint Mobilisation Techniques
- Kinesiology Tape
- Physiotherapy Instrument Mobilisation (PIM)
- Running Analysis
- Stretching Exercises
- Supportive Taping & Strapping
- TENS Machine
- Video Analysis
Who is a Sports Physiotherapist?
Sports Physiotherapy is the specialised branch of physiotherapy which deals with injuries and issues related to spokespeople. Practitioners with additional formal training within Australia are Sports & Exercise Physiotherapists.
What is Sports Physiotherapy?
Sports injuries do differ from common everyday injuries. Athletes usually require high-level performance and demand placed upon their body, which stresses their muscles, joints and bones to the limit. Sports physiotherapists help athletes recover from sporting injuries, and provide education and resources to prevent problems.
Each sports physiotherapist usually has sport-specific knowledge that addresses acute, chronic and overuse injuries. Their services are generally available to sportsmen and women of all ages engaged in sports at any level of competition.
Members of Sports Physiotherapy Australia (SPA) have experience and knowledge of the latest evidence-based practice, skilled assessment and diagnosis of sports injuries, and use effective 'hands-on' management techniques and exercise protocols to assist recovery and prevent future damage. SPA members have access to the most recent advances in sports physiotherapy. You'll be pleased to know that most of PhysioWorks physiotherapists and massage therapists have a particular interest in sports injury management.
Musculoskeletal Physiotherapists have expertise in the treatment of musculoskeletal (muscle and joint) conditions. Musculoskeletal Physiotherapy employs advanced clinical assessment and diagnosis methods. Musculoskeletal physiotherapists and have been trained in a broader range of treatment techniques and normally hold a Masters of Physiotherapy qualification.
Members of the Musculoskeletal Physiotherapists Australia (MPA) are world-leaders in the diagnosis, treatment and prevention of muscle and joint problems, especially spinal conditions that commonly cause lower back pain and neck pain.
How Can Musculoskeletal Physiotherapy Help You?
Your Musculoskeletal Physiotherapist can:
- Totally relieve or reduce your pain.
- Provide you with strategies to best manage your injury or condition.
- Help you to recover quicker and hasten your return to your normal activities.
- Improve your flexibility, muscle strength, quality of movement, proprioception and co-ordination.
- Assist you to achieve exercise or functional goals.
- Improve your fitness.
- Help you to prevent future injury recurrences.
- Prescribe exercises to do at home, work in the gym to enhance your recovery.
What is Physiotherapy Treatment?
Physiotherapists help people affected by illness, injury or disability through exercise, manual joint therapy, soft tissue techniques education and advice. Physiotherapists maintain physical health, allow patients to manage pain and prevent disease for people of all ages. Physiotherapists help encourage pain-relief, injury recovery, enabling people to stay playing a sport, working or performing daily living activities while assisting them to remain functionally independent.
There is a multitude of different physiotherapy treatment approaches.
Acute & Sub-Acute Injury Management
Hands-On Physiotherapy Techniques
Your physiotherapist's training includes hands-on physiotherapy techniques such as:
- Joint Mobilisation (gentle joint gliding techniques)
- Joint Manipulation
- Physiotherapy Instrument Mobilisation (PIM)
- Minimal Energy Techniques (METs)
- Soft Tissue Techniques
Your physiotherapist has skilled training. Physiotherapy techniques have expanded over the past few decades. They have researched, upskilled and educated themselves in a spectrum of allied health skills. These skills include techniques shared with other healthcare practitioners. Professions include exercise physiologists, remedial massage therapists, osteopaths, acupuncturists, kinesiologists, chiropractors and occupational therapists, to name a few.
Your physiotherapist is a highly skilled professional who utilises strapping and taping techniques to prevent and assist injuries or pain relief and function.
Alternatively, your physiotherapist may recommend a supportive brace.
Acupuncture and Dry Needling
Many physiotherapists have acquired additional training in acupuncture and dry needling to assist pain relief and muscle function.
Physiotherapists have been trained in the use of exercise therapy to strengthen your muscles and improve your function. Physiotherapy exercises use evidence-based protocols where possible as an effective way that you can solve or prevent pain and injury. Your physiotherapist is highly-skilled in the prescription of the "best exercises" for you and the most appropriate "exercise dose" for you, depending on your rehabilitation status. Your physiotherapist will incorporate essential components of pilates, yoga and exercise physiology to provide you with the best result. They may even use Real-Time Ultrasound Physiotherapy so that you can watch your muscles contract on a screen as you correctly retrain them.
- Muscle Stretching
- Core Exercises
- Strengthening Exercises
- Balance Exercises
- Proprioception Exercises
- Real-Time Ultrasound Physiotherapy
- Swiss Ball Exercises
Biomechanical assessment, observation and diagnostic skills are paramount to the best treatment. Your physiotherapist is a highly skilled health professional. They possess superb diagnostic skills to detect and ultimately avoid musculoskeletal and sports injuries. Poor technique or posture is one of the most common sources of a repeat injury.
Aquatic water exercises are an effective method to provide low bodyweight exercises.
Sports physio requires an extra level of knowledge and physiotherapy to assist injury recovery, prevent injury and improve performance. For the best advice, consult a Sports Physiotherapist.
Women's Health Physiotherapy is a particular interest group of therapies.
Not only can your physiotherapist assist you in sport, but they can also help you at work. Ergonomics looks at the best postures and workstation set up for your body at work or home. Whether it be lifting technique improvement, education programs or workstation setups, your physiotherapist can help you.
Plus Much More
Your physiotherapist is a highly skilled body mechanic. A physiotherapist has particular interests in certain injuries or specific conditions. For advice regarding your problem, please contact your PhysioWorks team.