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FIFA Diploma in Football Medicine: The Ankle

1. The ankle is the most commonly injured joint.

“The ankle is the most commonly injured joint in sport. In international football, ankle injuries constitute 11% to 23% of all injuries recorded during FIFA competitions.1 The rate of ankle injuries in lower-level amateur players, children and adolescents is higher still, representing 35% of all injuries.”

The word sPrain refers to an injury of a ligament. A ligament is the tissue that connects bone to bone. A sTrain refers to an injury of the muscle or tendon. A tendon connects the muscle to bone.

Mechanisms of injury: “cutting, running on uneven ground or landing on an opponent’s foot.”

Pain during shooting (kicking the ball) may indicate an injury to a tendon.

These injuries most commonly occur on the outside of the ankle and are called inversion sprains.

2. Indications that you need an X-Ray:

  • Pain when you touch the inside bony prominence of the ankle

  • Pain when you touch the outside bony prominence of the ankle

  • Inability to bare weight for 4 steps

Fractures can be seen on X-rays.

3. Self Examination – see above and add:

  • Is your ankle swollen?

  • Can you walk normally and without pain?

  • Can you squat up and down without pain?

  • Can you walk on your toes and on your heels without pain?

  • Squeeze the Achilles tendon – do you have pain?

4. Acute injury treatment: PRICE – Protection, Rest, Ice, Compression, and Elevation

5. Rehabilitation

“Rehabilitation should progress … from … linear movements (e.g. toe-raises, squats, jogging, jumping in place on two legs, then one, skipping-rope jumping) to cutting movements (e.g. running figures of eight, sideways jumping, sideways hurdle jumps). The goal of this progression of exercises is to gradually progress towards sport-specific exercises.”

See this video:

6. Prevention: Taping and Bracing

“There is no convincing evidence to show that either taping or bracing limits the risk of injury in athletes who have never sustained an ankle sprain before. Taping and bracing following injury, however, has been shown to reduce the risk of repeat sprains.6”

I will add that Kinesiotaping is a very effective taping method. As for bracing, proper fit is essential. The brace must prevent the motion that caused the injury. If you inverted your ankle (turned it inward), then the brace must prevent this motion, but not prevent toe and heel walking.

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