At some stage in life, many people will have experienced an ankle sprain. It is one of the most common sports related injuries that presents to physiotherapists and podiatrists and can require varying degrees of treatment. Whilst ankle sprains can be painful, they can also lead to ongoing issues such as recurrent ankle sprains and it is very important they are properly rehabilitated.
What Is An Ankle Sprain?
A lateral ankle sprain occurs when the foot rolls inward, placing a lot of load on the ligaments through the outside of an ankle. This load can stretch the ligaments beyond their capacity, leading to damage or even rupture. There are three grades of ankle sprain, each with increasing severity of damage to the ligaments:
Grade 1: Very minor tear of the lateral ankle ligaments. This leads to swelling and pain.
Grade 2: Partial thickness tears of the lateral ankle ligaments. This leads to moderate pain, swelling and reduced stability of the ankle joint during some clinical tests or movements.
Grade 3: Complete rupture of the lateral ankle ligaments. This leads to significant laxity within the ankle. After a grade 3 sprain, the ankle is quite unstable.
Many people will be familiar with a grade 1 ankle sprain. These commonly occur when stepping on uneven surfaces or “rolling your ankle” when playing sports. Unfortunately, there are a significant number of ankle sprains which are not rehabilitated properly and can lead to chronic instability and pain.
Why Do I Need To Rehabilitate My Ankle Sprain?
The idea of “walking it off” when it comes to an ankle sprain is not the best approach. Damaged ligaments need to be properly rehabilitated or there is a risk of improper healing, ongoing weakness and instability leading to recurrent ankle sprains.
The ligaments of the ankle are important for proprioception - that is the ability of your brain to know where your limb is in space. If your brain is not able to detect where your foot and ankle is sitting, it is much more likely to end up in a compromised position. And if your ligaments have already been stretched and weakened, this can lead to an even more serious ankle sprain next time.
Rehabilitation Of A Sprained Ankle
The grade of ankle sprain will determine your rehabilitation protocol and recovery time, however even complete ruptures can heal without surgery if appropriately immobilised and rehabilitated. Typically rehabilitation will follow the below protocol:
First 48-72 hours: Follow RICE principles of Rest, Ice, Compression and Elevation. This is aimed at reducing pain and inflammation.
After this, it is best to begin weight bearing if possible. If weight bearing is not possible, crutches can be used to reduce the load placed on the foot and ankle aiming for partial weight bearing as soon as possible.
Active range of motion exercises should be commenced as soon as pain allows. These include gently pulling back and planting your foot and gentle rotations of your foot. This works to ensure the joint stays mobile and does not become stiff.
After range is restored, it is very important to build strength and proprioception within the foot and ankle. Working with your podiatrist, exercises using resistance bands will be prescribed with particular focus on eversion - building the muscles through the outside of the leg to provide stability.
Proprioception can be improved by testing the foot on a range of uneven surfaces. At first this may involve standing on one foot (you will likely find the injured side is much less stable). This can then be progressed to standing on an uneven surface such as a cushion or a Bosu ball, standing on one foot on this uneven surface and even progressing to squats.
By appropriately rehabilitating your ankle sprain, you significantly reduce the likelihood of ongoing ankle sprains and further damage. Your podiatrist can also assess your footwear and foot posture and discuss if this is contributing to your ankle sprain risk. If you have had an ankle sprain and feel you need assistance in returning to full function, give the team at My Family Podiatry a call on 07 3088 6116 or book an appointment through our website!