Experiencing a 3rd degree ankle sprain can be a significant setback, especially for pole dancers and athletes who rely on strong, stable movements. Whether you’re performing aerial routines or everyday activities, understanding how to manage and prevent severe ankle injuries is crucial.
Your passion might be to be up in the air, “flying” as you perform your favorite aerial or pole dancing routine. But don’t forget about the safe landing! The chances of experiencing an ankle sprain are not uncommon, especially when wearing high-heeled shoes. That’s why Nael Chrisafidis, a physiotherapist, explains what an ankle sprain is, how it can occur, and how it can be treated.
What is an ankle sprain?
An ankle sprain refers to the disruption of the ligaments in the ankle joint. Sometimes, an ankle sprain may also involve a bone fracture, making it a mixed traumatic injury. About 85% of ankle sprains involve the complex of ligaments located on the outer surface of the ankle, consisting of the anterior talofibular ligament (ATFL), the calcaneofibular ligament (CFL), and the posterior talofibular ligament (PTFL). The ATFL is almost always affected, while the CFL and PTFL are less frequently injured.
An ankle sprain is clinically classified into three grades:
- 1st degree: Ligament stretching or a mild tear (Ankle Strain).
- 2nd degree: Partial ligament tear (Ankle Sprain).
- 3rd degree: Complete ligament tear (Ankle Ligament Tear).
Treating an ankle sprain requires a comprehensive approach that may involve rest, ice, compression, elevation (R.I.C.E.), immobilization with a brace or cast, physical therapy exercises, and in severe cases, surgery. It’s essential to seek proper medical evaluation and follow the recommended treatment plan to ensure a full recovery.
Remember, taking care of your ankles and practicing proper techniques and precautions can help minimize the risk of ankle sprains, allowing you to enjoy your aerial or pole dancing activities safely.
How likely are we to experience an ankle sprain?
It is estimated that 100% of people have either experienced or will experience an ankle sprain at some point in their lives, with over 50% of them experiencing it more than once. Furthermore, it is estimated that 80% of ankle sprains are classified as first-degree, 15% as second-degree, and 5% as third-degree.
How can we get injured?
The mechanism of injury occurs through forceful stretching of the ligaments, either with or without plantar flexion for the outer surface, or forceful stretching of the ligaments with inversion for sprains affecting the inner surface.
Specifically, for individuals practicing pole fitness, common mechanisms of injury include:
Landing after a jump, such as jumping out from the pole or performing flips while landing on the ground. The forces exerted on the foot upon landing can exceed the limits of what the ligaments, muscles, and soft tissues of the joint can stabilize, resulting in forceful stretching of the inner ligaments and injury or rupture of the ligaments on the outer surface of the ankle.
Symptoms of a 3rd Degree Ankle Sprain
The symptoms vary depending on the degree of injury but generally include:
- Pain
- Swelling, effusion, bruising
- Reduced range of motion
- Limping while walking
- Instability
- Cold sensation or numbness (in cases where the injury affects the nerve tissue)
First aid for an ankle sprain
When dealing with an ankle sprain, it is important to apply the appropriate first aid measures.
First of all, it is essential to determine whether it is indeed an ankle sprain as it may also be a fracture, and in some cases, both may occur. If the injury is severe, the activity should be immediately stopped, and the ankle should be immobilized with an elastic bandage to ensure there is no fracture. If there is suspicion of a fracture, a medical examination by an orthopaedic surgeon should be performed, and the patient should avoid putting weight on the foot until a diagnosis is made. Other conditions that present similar symptoms to an ankle sprain and require differential diagnosis include fibular fractures, ankle fractures, medial malleolus fractures, tarsal fractures, metatarsal fractures, chondral fractures (which are not visible on X-rays), osteochondral fractures in children and adolescents, tendon ruptures, etc.
How is a 3rd Degree Ankle Sprain Treated?
Treatment for a 3rd degree ankle sprain often includes immobilization, physical therapy, and in rare cases, surgery. Previously, treatment for “clean” sprains involved immobilization with a cast for extended periods, which ultimately led to complications and increased recovery time. Nowadays, the preferred method is early mobilization.
For first-degree sprains:
Treatment may include elastic bandages for joint stabilization and edema reduction, warm water soaks, or ice therapy for edema and pain reduction. Walking is allowed from the first day, and from the second day, gentle exercises for strengthening and stabilizing the joint, as well as proprioception exercises for balance retraining and prevention of recurrence, can be performed. Generally, first-degree sprains heal within 7 days, and return to sports is permitted within 10 days.
For second-degree sprains:
Immediate cessation of sports activity is necessary, followed by immobilization with a compression bandage and ice therapy, warm water soaks, manual lymphatic drainage, and gentle mobilization exercises from the second day. Walking with partial weight-bearing (using crutches) is recommended for 5 to 10 days. As the days progress, progressive exercises for strengthening and stabilizing the joint, as well as proprioception exercises, are incorporated into the rehabilitation program. Typically, these sprains require 15 to 20 days for recovery, with a full return to sports within one month. In cases of significant pain and swelling, physical modalities such as TENS, pulsed magnetic fields, and laser therapy can be applied, along with non-steroidal anti-inflammatory drugs and the use of a plastic stabilizing brace. Additionally, the application of kinesiology tape is helpful for many patients.
For third-degree sprains:
These are more severe sprains with significant instability, pain, and swelling in the joint. In many cases, surgical ligament repair may be necessary. However, recent research indicates that even in high-performance athletes, the best therapeutic approach is conservative. This includes the use of a cast or another type of immobilization, non-weight-bearing walking with crutches for 10 days, and immediate physical therapy. Return to work usually occurs within approximately 15 days, and return to sports is typically achievable within 30 to 60 days. Additionally, complications such as recurrent sprains due to instability are likely to occur in the future. Specialized exercises to strengthen the dynamic stabilizing tendons and muscles, the use of protective braces during sports activities, and in more severe cases, ligament or tendon reconstruction surgery can be helpful in these situations.
If chronic pain, swelling, stiffness, and difficulty in sports activities persist for more than 6 months in sprains without fractures, a differential diagnosis by an orthopedic specialist should be sought, as there may be conditions such as chondral fractures, post-traumatic osteophytes, post-traumatic instability, intra-articular loose bodies, osteochondral defects, osteochondritis dissecans, avascular necrosis of bone, arthritis, etc.
Exercises to Prevent a 3rd Degree Ankle Sprain
Prevention of ankle sprains depends on the type of physical activity we engage in. In any case, athletes should understand the nature of their sport and follow appropriate warm-up, conditioning, and strengthening programs to reduce or avoid future injuries. Research has also shown that poor muscle coordination and excessive weight increase the likelihood of ankle sprains.
Regarding pole dancing, practitioners should follow the above guidelines. They should perform techniques that increase the likelihood of ankle sprains (e.g., flips and jump-outs) with a spotter until they fully understand and can execute them safely. If they choose to wear high-heeled shoes, it is advisable to gradually increase the heel height to ensure safety.
If you’re looking for more tips, be sure to check out our article tips on preventing and treating exercise-related injuries.
