How long until I can play on this ankle?
HOW LONG UNTIL I CAN PLAY ON THIS ANKLE?
In any sport demanding agility and changes of direction, such as football or netball, ankle injuries are almost a fact of life. Strange how they always seem to happen right on the eve of big games or finals, too, isn’t it?
The first question we’re usually asked as physiotherapists when presented with an ankle injury is rarely, “what’s the injury?”.
Inevitably, it’s “when can I play again?”. It’s a loaded question, of course, and the answer will vary based on a number of different factors.
THE ANKLE STRUCTURE
To help you better understand how we assess the severity and likely recovery time of your ankle injury, it’s important to understand the structure of the ankle and how you’re likely to injure it.
There are three main ligaments on the outside of the ankle, which can be injured individually or together. These ligaments are commonly torn due to the comparative weakness from the medial, or inside, ligament.
Often the first to tear is the ATFL – anterior tibiofibular ligament. Then there’s the CFL – calcanofibular ligament – which is less likely to be the first to go. It is rare to tear the third ligament, the PTFL – posterior tibiofibular ligament – without damaging the first two.
Often when rolling their ankle, people describe hearing a loud “crack” – but unlike knee injuries, the sound is quite common and isn’t necessarily cause for concern.
GRADE ONE INJURY
Ligament injuries are divided into three categories: grade one, grade two and grade three, depending on severity.
Grade one tears are the least severe – often only microtears in the ligament with some stretched fibres but no loss of stability through the ankle. You’ll feel a bit of a sting and sometimes you might not be able to finish your game or training. Often there’ll be swelling and bruising, and it’s important that you rest it, ice it and compress it in order to keep the swelling down.
The ankle will often be quite stiff over the next two to three days, and it’s important to then begin regaining movement. Once pain-free, you can start working towards full strength and balance. While some people can return to sport sooner, often a grade one injury will have you out for between two and four weeks.
GRADE TWO INJURY
Grade two injuries are very common and are more severe than a grade one tear. It’s a significant tear, which leads to a loss of ankle stability and a likelihood of re-injury if you don’t rehabilitate it property. Again, it’s crucial to rest the ankle after the injury, along with ice, compression and elevation. Some people may require crutches to keep the weight off the injury for a couple of days. With proper management and treatment, a grade two injury will usually keep you off the park for between five and eight weeks
GRADE THREE TEAR
“Grade three” are the words you’d prefer not to hear. It means a complete rupture of any or all of the ligaments. If all three ligaments are torn completely, the ankle may dislocate as there is nothing to stabilize it. Strangely, some athletes who rupture multiple ligaments experience little pain afterwards, as there are no fibres left intact to cause any pain. Providing an estimated recovery time for a grade three tear is difficult, as a scan is often required, and in severe cases surgery may be necessary.
THE FIRST STEP
With all ankle injuries, it is best to see your physiotherapist within the first three or four days, to allow for an accurate diagnosis and the best treatment plan. If you have any questions about ankle injuries, or preventative measures including taping and strength exercises, don’t hesitate to contact the clinic or email us – [email protected].
Kaitlyn completed her Bachelor of Physiotherapy through Monash University. Since then she has worked closely with Melbourne’s leading orthopaedic surgeons in private hospitals . Her keen love for sport and maintain an active lifestyle has taken her all over Melbourne’s sporting landscape, as well as playing elite level netball herself in both the Victorian and Australian Netball Leagues.