"It's Not Just An Ankle Sprain"
Ankle Sprains: The ankle joint and its surrounding joints are a very complex part of the body. The up and down motion comes truly from the ankle joint. Three major bones allow this to occur. The fibula (outside ankle bone), the tibia (the inside and central bone) and the talus (the bottom bone). The additional in and out motion of the ankle actually comes from two entirely different set of bones making up two entirely different sets of joints that sit just below and in front of the ankle joint. The majority of the in and out motion, technically called inversion and eversion respectfully, is made up by the talus (but here forming the top bone) and the calcaneus (the bottom bone). This joints formal name is called the sub talar joint. The additional in and out side to side motion comes from the mid tarsal joint made up from again the talus and the navicular medially and the calcaneus and cuboid laterally.
The bones forming the complex joints of the ankle, sub talar and mid tarsal joints are held together by a complex set of ligaments which can be thought of as leather straps going from bone to bone. Ligaments are made up of strong collagen fibers. Any one of these ligaments when injured can reduce the stability of the involved joint and can pull off a piece of bone at its attachment causing a fracture or break in the bone.
The normal physiological healing of these ligaments is up to 4 weeks. During that time it is important to immobilize or protect these structures in an ankle brace or fracture boot or even a cast. However, while the ligament heals the rest of the leg muscles become weakened. Once the ligament has a chance to heal, it still can take another 4 to 8 weeks to rehabilitate the entire leg including the injured ligament as well as the rest of the leg muscles. If the bone is involved the immobilization phase can be up to 6-8 weeks alone followed by 8 -12 weeks of rehabilitation. Complete healing and maturation of the involved area can physiologically take up to 6 months to 1 year from the time of injury. Once injured the ankle and involved joints can be more susceptible to injury in the future.
If the involved joint does not show improvement in the first 3-6 weeks, then additional diagnostic tests may be indicated such as an MRI, CT Scan, Bone Scan, Neurological Studies etc.