Solihull Sports Injuries Clinic offers new sports injury advice line to Solihull, Birmingham and Tamworth Marathon Runners

Marathon running and high mileage training can lead to overuse injuries and tiredness can give rise to ligament sprains.

Ankle ligament sprains

The most common ligament damaged when you sustain an ankle sprain is the Anterior Talofibular Ligament. Most ankles are injured when you turn your ankle with the sole of your foot inwards, which is called an inversion sprain. In most cases the ankle is at more risk when walking downhill on uneven ground. Running sports where twisting and turning is required are high risk from ankle sprains

The mechanical design of the ankle joint gives it stability and mobility during different phases of gait.
The Talus bone sits between the 2 ankle bones of the Tibia and Fibula and when the foot is pulled upwards (dorsi-flexion) such as walking on your heels, the ankle benefits from more stability due to the wedge shaped Talus bone sitting tighter between the Tibia and Fibula. This restricts movement side to side and thus protects turning of the ankle.

When you walk on your toes the foot is in plantar-flexion and the thinner edge of the wedge shaped talus is now engaged. This allows side to side movement and it is in this state that more ankles are sprained.

The foot and ankle have very complex biomechanics and are too involved to discuss at this time however in simplistic terms, the foot needs to be both a rigid lever and a mobile adapter during different phases of the gait cycle. The ankle therefore needs to lock and unlock at various times to give both stability and mobility and is most at risk of injury during the mobility phase.

The anterior talofibular ligament is put on stretch during plantarflexion and inversion and any undue exaggeration of this movement will sprain fibres of this ligament and cause injury which is extremely painful. Swelling can occur if the capsule is damaged and bruising may follow if small blood vessels are damaged.

Ligaments are very slow to heal due to their poor blood supply. It is often said that a fracture to an ankle bone will be less painful and heal faster than a sprained ankle ligament. This is due to the contrasting blood supply to both structures. Bones have a very good supply of blood which carries all the repair materials and ligaments have by comparison a poor supply of blood.

During injury to the ankle, small sensory nerves called proprioceptors can be damaged and all good therapists should ensure that re-education of proprioceptors takes place as a part of the rehabilitation process. Ankle ligaments respond well to therapeutic ultrasound treatments and ice, contrast bathing and support strapping whilst waiting for nature to heal the injury will help.

When strapping the ankle, non stretch tape such as zinc oxide should be used, but be aware that some people can have allergies to this tape. The ankle should be taped in dorsiflexion and eversion to help prevent unwanted movement into inversion, which puts a strain on the lateral (outside) ankle ligaments.

Sports injuries are a speciality at the Atlas group of sports injury clinics which are located in Solihull, Birmingham, West Midlands and Tamworth, Staffordshire. The website is well worth a visit and can be found on www.solihullsportsinjuryclinic.co.uk or www.atlaspainrelief.com