Ankle Sprains in Crossfit Athletes

Ankle sprains are not unique to Crossfit athletes, but are a frequent injury in the Crossfit community. There are three different ankle sprains. 

Types of Ankle Sprains 

  • Inversion sprains

An inversion ankle sprain is the most common type of sprain. It occurs when the ankle rolls outwards causing stress to the ligaments on the outside of the ankle. The most frequently injured ligament is the anterior talofibular ligament (ATFL), followed by the talocalcaneal ligament, and finally the posterior talofibular ligament. 

  • Eversion sprains

This is a fairly uncommon injury because the ligaments on the inside of the ankle are much stronger than the ones on the outside. An eversion ankle occurs when the ankle rolls inwards causing stress to the deltoid ligament on the inside part of the ankle. 

  • High ankle sprains

High ankle sprains, also referred to as a syndesmosis ankle sprain, occur when the ankle is twisted causing an injury to the ligament connecting the tibia and fibula bones. These types of ankle sprains generally take the longest to heal of all of the ankle sprains. 

Imaging for ankle sprains 

The Ottawa Ankle Rules are used to determine whether an X-ray is necessary. The main concern with an ankle sprain is the possibility of a fracture to one of the ankle bones. 

The Ottawa Ankle Rules recommend imaging when one of the follow is present after an ankle injury: 

  • Tenderness on the medial or lateral malleolus
  • Tenderness on the 5th metatarsal head or navicular bone, or 
  • Inability to bear weight after injury

Treatment of ankle sprains

While PRICE has been a popular treatment approach to ankle sprains, it appears that MEAT may be a better approach. The MEAT approach encourages earlier movement which helps accelerate healing and strengthen the ankle as opposed to the PRICE method. 

PRICE: Protection, Rest, Ice Compression, Elevation
MEAT: Mobilization, Exercise, Analgesics, Treatment

Early mobilization of the ankle helps to decrease stiffness often associated with ankle sprains and also helps to maintain range of motion in the joint. Early mobilization combined with controlled exercise loading as promotes circulation in the ankle region, bringing nutrients for healing and removing byproducts from the injury. 

Other treatments can include manual therapy, such as myofascial release and Graston. Both of these therapies are used to reduce ankle and maintain/increase range of motion in the ankle following an injury. 

The rehab programs for the different types of ankle sprains varies slightly. For inversion sprains, the focus is on strengthening the peroneal muscles on the outside of the leg. The focus for eversion ankle sprains is on the posterior tibialis muscle on the inside of the leg. Whatever the specific type of ankle sprain, a comprehensive strengthening program for all of the muscles around the ankle is recommended.