This paper summarizes the current understanding on acute
ankle sprain injury, which is the most common acute sport
trauma, accounting for about 14% of all sport-related
injuries. Among, 80% are ligamentous
sprains caused by
explosive inversion or supination. The injury motion often happens at the subtalar joint and tears the anterior talofibular ligament (ATFL) which possesses the lowest ultimate load among the lateral ligaments at the ankle. For extrinsic risk factors to
ankle sprain injury, prescribing
orthosis decreases the risk while increased exercise intensity in soccer raises the risk. For intrinsic factors, a foot size with increased width, an increased ankle eversion to inversion strength, plantarflexion strength and ratio between dorsiflexion and plantarflexion strength, and limb dominance could increase the
ankle sprain injury risk. Players with a previous
sprain history, players wearing shoes with air cells, players who do not stretch before exercising, players with inferior single leg balance, and
overweight players are 4.9, 4.3, 2.6, 2.4 and 3.9 times more likely to sustain an
ankle sprain injury. The aetiology of most
ankle sprain injuries is incorrect foot positioning at landing - a medially-deviated vertical ground reaction force causes an
explosive supination or inversion moment at the subtalar joint in a short time (about 50 ms). Another aetiology is the delayed reaction time of the peroneal muscles at the lateral aspect of the ankle (60-90 ms). The failure supination or inversion torque is about 41-45 Nm to cause ligamentous
rupture in simulated spraining tests on cadaver. A previous case report revealed that the ankle joint reached 48 degrees inversion and 10 degrees internal rotation during an accidental grade I ankle ligamentous
sprain injury during a dynamic cutting trial in laboratory. Diagnosis techniques and grading systems vary, but the management of ankle ligamentous
sprain injury is mainly conservative. Immobilization should not be used as it results in joint stiffness,
muscle atrophy and loss of proprioception.
Traditional Chinese medicine such as herbs,
massage and acupuncture were well applied in China in managing
sports injuries, and was reported to be effective in relieving
pain, reducing swelling and
edema, and restoring normal ankle function. Finally, the best practice of sports medicine would be to prevent the injury. Different previous approaches, including designing prophylactice devices, introducing functional interventions, as well as change of games rules were highlighted. This paper allows the readers to catch up with the previous researches on
ankle sprain injury, and facilitate the future research idea on sport-related
ankle sprain injury.