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26 m a s s a g e & b o d y wo r k j a n u a r y/ fe b r u a r y 2 0 24 Ankle sprains are among the most common injuries encountered in both athletic and general populations, affecting millions globally every year. This pervasive injury can significantly impact an individual's daily activities, athletic performance, and quality of life. The nature of an ankle sprain, often resulting from a sudden twist or misstep, can lead to varying degrees of ligament damage, pain, and functional impairment. The ankle is a complex structure, stabilized by an intricate network of ligaments, tendons, and muscles, all working together to facilitate movement and bear the body's weight. Massage therapists can play an important role in treating this condition and helping clients return to activity. Let's explore the key aspects of anatomy, biomechanics, assessment, and treatment for these common soft-tissue disorders. ANATOMY The ankle region is a complex structure, incorporating bones, joints, and soft tissues that work together to allow locomotion. They provide strength, stability, and f lexibility essential for daily activities and dynamic movements. Let's delve deeper into ankle sprains, starting with the bones. The ankle comprises multiple joints, with four main bones playing key roles in ankle function: the tibia, fibula, talus, and calcaneus (Image 1). The tibia bears the brunt of the body's weight, while the fibula is a support and attachment point for muscles. Together, they rest upon the talus, which in turn transfers force to the calcaneus below. This arrangement creates Bones and joints that make up the ankle complex. Image courtesy of Complete Anatomy. 1 KEY POINTS • Ankle sprains typically occur in one of three areas—lateral, medial, or syndesmosis. • Massage therapy is a core component for treating ankle sprains and is used with other treatments used by other providers, such as laser therapy, ultrasound, microcurrent, and electrical stimulation. CLINICAL EXPLORATIONS By Whitney Lowe Ankle Sprains A Rehabilitation Road Map a stable yet adaptable foundation for efficient movement and shock absorption. Three main joints form the ankle complex: the talocrural, subtalar, and distal tibiofibular joints (Image 1). The talocrural joint is where the tibia and fibula meet the talus. The subtalar joint lies between the talus and calcaneus, and the distal tibiofibular joint connects the lower ends of the tibia and fibula. Ligaments play a crucial role in ankle stability, spanning these joints. The ankle ligaments are grouped into three categories: lateral, medial, and syndesmotic. The lateral ligaments, consisting of the anterior talofibular ligament (ATFL), posterior talofibular ligament (PTFL), and calcaneofibular ligament (CFL), work synergistically to prevent foot inversion and offer lateral stability (Image 2). On the medial side, four ligaments make up the deltoid ligament complex (Image 3) and are referred to as the deltoid ligament; they resist eversion. The syndesmotic ligaments, running between the distal ends of the tibia and fibula, provide stability and protection against forces attempting to separate these bones (Image 3). Talocrural joint Talus Tibia Fibula Syndesmosis joint Subtalar joint Calcaneus TECHNIQUE