Ankle Sprains

 

ankle_sprain_smallAn ankle sprain is a common injury that occurs during sports or daily activities like walking on uneven surfaces. Ankle sprains often result in damage to the ligaments that stabilise the joint but more serious injuries such as cartilage damage or fractures to the ankle bones may happen.

The most common ankle sprain is an inversion sprain where the foot/ankle rolls inwards and downwards. In this type of sprain, ligaments on the outer ankle are involved (the Anterior Talo-Fibular Ligament, ATFL; the Calcaneo-Fibular Ligament, CFL; and the Posterior Talo-fibular Ligament, PTFL). After the initial sprain, there is usually immediate ankle pain and swelling at the outer portion of the ankle, and some bruising may appear over the days. It may be difficult to put full weight on the ankle and walking may become painful.

ankle_sprain_typesLess common sprains include eversion sprains (involving ligaments on the inside of the ankle), high ankle sprains (involving the syndesmosis, a connective structure between the 2 leg bones), and low ankle sprains (involving the bifurcate ligament which lies near the midfoot).

Imaging of the ankle may be required and your healthcare provider will assess you to see if it is indicated.

Ankle stiffness and impaired balance after sprains have correlation to long term Chronic Ankle Instability (CAI). Therefore, physiotherapy rehabilitation of a sprained ankle is important in assisting recovery and returning back to function. Management of ankle injuries depends on the severity of the sprain and the structures involved. In general, the PRICE principle is applied in the acute stage.

PRICE:

  • Protect: Limit movement of the ankle joint for the first few days with rigid tape, brace or splints. You may need to use crutches depending on your symptoms and severity of sprain.
  • Rest: Rest the ankle for the first few days to allow recovery.
  • Ice: Ice 15-20 minutes every 2 hours for the first 1-3 days to reduce inflammation and pain.
  • Compress: Use elastic, tubular compression bandage to bring down swelling.
  • Elevate: raise injured ankle above heart level to facilitate reduction of swelling.

Analgesics and anti-inflammatories may also be required in this stage to help with pain and inflammation.

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Depending on the severity of the injury, Physiotherapists will use a range of treatment techniques such as soft tissue massage, joint mobilisation, strapping, electrical modalities and individualised exercise programs. As your injury recovers, your physiotherapist will help you with self-management strategies to prevent recurrent sprains.