Ankle Sports Injuries: Detailed Guide and Treatment Programs

The ankle is a critical joint that bears the weight of the body and provides mobility. Due to its complex structure, it can often be exposed to injuries during sports activities. The severity of injuries can range from mild sprains to bone fractures and can lead to long-term problems if treatment is not started on time. In this guide, you can find a detailed analysis of ankle sports injuries, specific treatment approaches for each type of injury, and safe return to sports programs.

Structural and Functional Basis of Ankle Injuries

Ankle; It is formed by the connection between the tibia, fibula (small tibia) and talus (lover’s bone). The junction of these bones is supported by ligaments and muscles:

• Medial (internal) and lateral (external) ligaments provide stability of the joint.
• The Achilles tendon connects the calf muscles to the heel bone, supporting propulsion.
• The peroneal and tibial tendons control the movements of the ankle and contribute to stability.

The ankle is subjected to intense stress in athletes due to its functions such as load-bearing, balancing and sudden change of direction.

Types of Ankle Injuries

1. Ankle Sprains

Definition

It is the stretching or rupture of the ligaments as a result of the ankle going beyond the normal limit of movement. It is one of the most common types of sports injuries.

Causes

• Sudden change of direction or poor landing after jumping.
• Running on uneven ground.
• Wrong choice of shoes or insufficient heating.

Severity Ratings

• Grade 1: Mild ligament stretching, minimal pain and swelling.
• Grade 2: Partial rupture of ligaments, moderate pain, swelling and bruising.
• Grade 3: Complete rupture of ligaments, severe pain, significant instability and limitation of movement.

Treatment and Rehabilitation

Acute Period (First 48-72 Hours):

• RICE protocol: Rest, ice, compression, and elevation.
• Anti-inflammatory drugs to reduce pain.

Subacute Period: The healing of the ligaments is supported by physical therapy.

• Exercises to increase range of motion.
• Proprioception (balance) training.

Return to Sports: Sports-specific exercises after full ligament recovery is achieved.

2. Achilles tendon injuries

Definition

Inflammation, degeneration or rupture of the Achilles tendon. The frequency of injury is quite high in athletes.

Causes

• Overuse and insufficient rest.
• Choice of flat feet or unsuitable shoes.
• Suddenly intensified sports programs.

Types of Injuries

• Tendonitis: Tendon pain and tenderness as a result of inflammation.
• Tendinosis: Structural weakening of the tendon by chronic microtraumas.
• Tendon Rupture: Complete rupture of the tendon as a result of a sudden strain.

Treatment and Rehabilitation

Tendinitis and Tendinosis:

• Resting and limiting loading.
• Ice and anti-inflammatory drugs.
• Increasing tendon strength with eccentric exercises.

Tendon rupture:

• 6-12 months of rehabilitation after surgical repair.
• The first 6 weeks are immobilization, followed by a phased exercise program.

3. Peroneal Tendon Injuries

Definition

Inflammation, subluxation, or rupture of the peroneal tendons located on the outside of the ankle.

Symptoms

• Pain and tenderness on the outside of the ankle.
• Crackling sensation during tendon movement.
• Loss of strength during movement.

Therapy

• Rest and the use of orthopedic support.
• Physical therapy: Tendon flexibility and stability are increased.
• Surgical repair in severe cases.

4. Stress Fractures

Definition

As a result of overload, microcracks form in the ankle bones.

Symptoms

• Localized pain usually increases during activities.
• Swelling and tenderness.
• Persistent discomfort during movement.

Therapy

• Activity modification and rest.
• Avoiding strenuous activities (4-6 weeks).
• Immobilization and physical therapy if necessary.

5. Ankle Fractures

Definition

As a result of sudden trauma, fractures occur in the ankle bones.

Therapy

• Stabilization with a cast or splint in mild fractures.
• Surgical intervention in complex fractures.
• Rehabilitation and return to sports between 3-6 months.

Comprehensive Treatment Approach in Ankle Injuries

Diagnosis

• Correct classification of injury by physical examination, x-ray and magnetic resonance imaging (MRI).

Therapy

• Conservative or surgical approach, depending on the type and severity of the injury.
•  Accelerating the healing process with injection treatments (PRP, PRGF or corticosteroids).

Rehabilitation

• Exercises that increase range of motion, balance and muscle strength.
• Sports-specific preparation programs.

Back to Sports

• After full recovery of the injury, return to sports with training and tests for sports performance.

Ways to Prevent Ankle Injuries

• Strengthening Exercises: Strengthen the muscles and ligaments around the ankle.
• Warm-up and Stretching: Prepare the ankle without straining by warming up enough before sports.
• Choosing Suitable Shoes: Use shoes that are suitable for the foot structure and provide sufficient support.
• Technical Training: Reduce stress on the ankle with the right sports techniques.
• Activity Management: Gradually increase training intensity and make time to rest.

Ankle injuries can be fully healed with early intervention and proper treatment. Correct rehabilitation and prevention methods during the recovery process after injury accelerate the return to sports and prevent recurrent problems. If you are experiencing a problem with your ankle, contact a specialist for proper diagnosis and treatment. We are with you for a healthy life and sports performance!