Sprained Ankles and Osteopathy….We Can Help!


Hey everyone it’s John, the Osteopathic Manual Practitioner at Fortius Physiotherapy and Wellness in Fort Erie. I’m going to be looking at the ankle and the injuries and the pains that can be associated with it. We will have a look at some basic anatomy and the mechanisms of injury and then how Osteopathy can help with these ankle problems.

So, let's start with the anatomy, it’s worth thinking of the ankle and a ‘Mortise and Tenon’ type of joint. Made up of the Fibula on the outside, the Tibia on the inside and the Talus making up the lower part of the ankle joint. Let’s have a little glance at the diagram below to better orientate yourself with the anatomy.

Now we can see how the bones look its worth remembering that these bones are held in place by strong ligaments that support the ankle yet allow enough movement so we can run, walk, or kick/control a ball etc. It is a classic  compromise between support and flexibility that also happens in all our other joints.

So let's see what can go wrong and why.

As mentioned above, the ankle joint is held together with strong ligaments and it is the overstretching of these ligaments, especially the Anterior (front) Talo-Fibula Ligament, which runs from the Talus to the Fibula, that can cause problems. It is most likely to be over stretched/sprained whilst doing fast/explosive side to side movements, commonly occurring in sports such as football, soccer, tennis and basketball and although it can happen in everyday situations such as tripping over a curb, missing a step and so on. The mechanism of injury is the same whether it occurs during sporting activities or not and that it is you usually rolling over the ankle towards the outside of you body. This causes elongation of the ligament(s), pain and is very usually accompanied by swelling and reduced movement. This is known as the classic ‘Inversion Ankle Sprain’, there is an ‘Eversion Ankle Sprain’ where the ankle rolls inwards towards the mid-line of your body, this is a much rarer occurrence and, in this sprain, it is damage of the Deltoid Ligament that causes the problems. The third type of ankle sprain is called a ‘High Ankle Sprain’ and as the name suggests it occurs higher up the ankle and affects the ligaments that join the Fibula and Tibia together. This type of injury usually occurs within contact or fast paced sports where lots of force is placed through the ankle.

Unfortunately, you may be predisposed to ankle sprains if you have incorrect footwear, slow neuron response, wearing high heels, weak muscles and tendons that cross the ankle joint or/and ‘lax’ ligaments. Lax ligaments can be due to hereditary reasons, or can be due to previous injuries. That is why it is paramount to get ankle sprains addressed to prevent future injuries, because even after the pain and swelling has subsided, if the ligament remains slightly more flexible than normal then there will be increased instability. As the ligaments won’t hold the bones as tightly together and this means there is more chance for injury, so this can produce a downward spiral where more injuries increase the chances of further injuries.

What can you do if you sprain your ankle? Feel free to call the clinic to book an appointment but also try to remember that encouraging some very gentle movement as pain levels allow can be beneficial in aiding in recovery, it can be useful to gently do the “Alphabet” with your foot, so gently making a figure ‘A, B, C, D …. and so on with the injured foot. Also protecting it from further injuries will always help during the healing phase.

So what can we do at Fortius Physiotherapy and Wellness Fort Erie for Sprained Ankles? We as Osteopathic Manual Practitioners use a variety of techniques to strengthen muscles, improve blood flow to an area, reduce pain and swelling, but we also work more ‘globally’ too. By this I mean we address the body as a whole and not only treat painful areas but try to get to the cause as well. For example, ensuring that the knee, hip and low back are functioning correctly so no abnormal forces are being placed through the ankle, acting as a risk factor for future ankle sprains. We work on the affected ligaments and help to promote an environment for effective healing and although it can take anything from 2 weeks to months to heal (depending on severity) we aim to get you back on your feet as soon as possible!! Come on in and lets get you better.


John Van Herbert, OMP