Hypomobility occurs at the subtalar, talocrural joint, distal tibiofibular joint, and proximal tibiofibular joint. Joint hypomobility can be intra-articular or extra-articular, giving rise to restricted range of motion at the ankle. A lesser known phenomenon is hypomobility leading to ankle instability. Residual MI usually results from a tear or lengthening of one of the ligamentous structures supporting the joint and suggests a suboptimal healing process after injury. Mechanical instability is defined as an increase in the accessory movements in the joint leading to hypermobility. Mechanical instability (MI) and functional instability (FI) are both due to recurrent lateral ankle sprains. There is loss of function, and joint motion and instability are markedly abnormal. Complete tears of ATFL and CFL with marked swelling, hemorrhage, and tenderness. Complete tear of ATFL with or without an incomplete tear of CFL with moderate pain, swelling, and tenderness over the involved structures some joint motion is lost, and joint instability is mild to moderate. There is an incomplete tear of ATFL with little swelling and tenderness, minimal or no functional loss, and no mechanical joint instability. There are three clinical grades of lateral ankle sprains. In the course of the inversion, the body’s center of gravity moves over the ankle leading to ankle sprains. In that position the ankle joint is the most unstable. The most common mechanism of injury in lateral ankle sprains is when, in forced plantar flexion, inversion occurs with excessive ankle supination. The PTFL is rarely injured as it is the strongest of all the three ligaments. In frequency of injury, the ATFL is followed by the calcaneofibular ligament CFL. The most commonly injured ligament is the ATFL as it is the weakest of all three ligaments. The lateral ankle compartment comprises the anterior talofibular ligament (ATFL), the calcaneofibular ligament (CFL), and the posterior talofibular ligament (PTFL). Hence, a personalized exercise protocol should be followed to achieve best results. The guidelines provided for the treatment of ankle sprains are of general validity, but each athlete is different with different needs. Grade III ankle injury may be treated with surgery if the symptoms persist post functional treatment. Bracing and taping of the ankle joint help in preventing the sprains and also reduce the recurrence of the injury. It also includes range of motion and strengthening exercises, proprioceptive training, and sports-specific exercises. Functional treatment includes RICE protocol, i.e., rest, ice, compression, and elevation. There are three grades of ankle sprains: Grade I, mild with an incomplete tear of ATFL Grade II, moderate with a complete tear of ATFL with or without an incomplete tear of CFL and Grade III, severe with complete tear of ATFL and CFL. Grades I and II respond well to functional treatment. The common mechanism of injury is inversion with excessive ankle supination in forced plantarflexion when the ankle joint is in its most unstable position. The most commonly involved ligament is the anterior talofibular ligament (ATFL), followed by the calcaneofibular (CFL) and posterior talofibular ligament (PTFL). Lateral ankle sprains are one of the most common injuries in athletes.
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