An inversion trauma (ankle sprain/strain) is defined as a strain or partial tear of the lateral ligaments (Lig. talofibulare anterior / Lig. calcaneofibulare / Lig. talofibulare posterior). Depending on the severity, we speak of a grade 1, 2 or 3.
Grade 1 is characterised by a strain of the ankle fibres with minimal swelling. However, the full function of the foot is preserved. In the more common grade 2, one sees a partial tear of the lateral ligaments, disturbed foot function, swelling and possibly reduced strength and/or proprioception. If a ligament is completely torn, one speaks of grade 3 where the foot may show severe instability along with a complete loss of foot function.
Ligaments, however, are important structures. They provide proprioceptive information about joint function, they ensure stability of the ankle and they control movement. To fulfil these functions, the collagenous tissue must not only be intact and of the correct length, but also have the necessary elasticity to allow movement.
Treatment of grade 1 & 2 mainly consists of rest, ice restrictions, gradual rebuilding of muscle strength and restoring proprioception through physical therapy.
If the symptoms persist and in order to prevent frequent ankle sprains, an extensive clinical and biomechanical examination is necessary before starting podiatric insole therapy. In addition, osteopathic examination is important to treat neck pain associated with ankle instability.
The treatment of grade 3 has to be done surgically to restore the stability of the foot, for which an orthopaedic foot surgeon is the reference.