Ankles

One of the commonest injuries at the ankle is a sprain of the ligament (running from bone to bone) on the outer aspect, from the base of the fibula to the calcaneum. Easily done, by missing your footing, or slipping, the foot turns in and the lower leg doesn't. The fibres of the ligament are over-stretched to varying degrees depending on the force involved.

There will be an inflammatory response at the time of injury. Inflammation is the body's defence response to injury, what you see is redness and swelling, what you feel is tenderness to the touch and pain on movement. A normal healthy inflammatory response is, if anything, rather overdone, so it is important to reduce swelling which in turn reduces pain and support the injured tissues, enough to make movement more comfortable and allow the ligament to repair (the inflammatory exudate contains fibroblasts, cells responsible for tissue repair). As the ligament heals it is important to keep the fibres approximated so that the ligament heals at the the appropriate length - not too long or the ankle will be unstable after repair, not too short or the ankle will lack its normal flexibility.

The ankle ligament contains loads of proprioceptors: nerve endings sensitive to position which feed up to the brain and inform balance reactions in the leg muscles. It is important to retrain these balance reactions after ankle injury, otherwise the ankle performs poorly on uneven ground or in complex rapid movements and the ligament will be vulnerable to re-injury.