Ankle sprains are among the most common injuries in active individuals, particularly with sports involving change of direction, twisting or landing from jumping. But you don’t have to be an athlete to injure your ankle. Many ankle sprains occur during normal daily activity while walking on an uneven surface, stepping in a pot hole, missing a step, or with trips or falls.
An ankle sprain is an injury that causes excessive stretch or tearing of one or more ligaments in the ankle joint. While the ligaments are the most commonly injured structure, bone, tendon or cartilage damage may also occur.
A number of factors have been shown to increase your risk of ankle injury. These include:
- Previous ankle injury – a past ankle injury is the greatest predictor of a future injury.
- Poor Proprioception (balance and control around the joint)
- Poor ankle range of motion (flexibility)
- Weak muscles of the lower leg
- Poor foot biomechanics – excessive rolling of the foot and ankle when you walk and run
- Ligament laxity (looseness) – can be genetic or the result of repeated over stretching
- Poor footwear, particularly high heels
- Sports history – sports that involve rapid change of direction, twisting, jumping and contact
- Environmental Factors – uneven, loose or slippery surfaces, pot holes, changes in levels – particularly in poor lighting
The consequences of an ankle injury can have a significant effect on your sporting, work and everyday life. Early and appropriate management is the key to a good outcome. How well you manage your ankle injury in the first 48 hrs makes a significant difference in your recovery time and in the prevention of complications.
The initial management of an ankle sprain, as with all soft tissue injuries, should follow the R.I.C.E.R protocol:
Rest – Stop activity, use crutches if weight bearing is painful, and immobilise the ankle. This protects the ankle from further injury, reduces pain and prevents disruption of the healing process.
(Note: Non weight bearing should only be continued for up to 48 hours, apart from in the most severe of injuries. At this point partial and then full weight bearing should be introduced).
Ice – The aim of cold application is to reduce pain, decrease bleeding and swelling, and reduce muscle spasm. Repeat cold therapy for 20 minutes every 2 hours on the first day and then every 4 hours on the second day and for at least 3 days after injury.
Compression – Apply compression to reduce bleeding and swelling.
Care should be taken not to over-tighten the bandage as this can cut off blood supply to the foot. If the toes become discoloured or become cold then it is possible that the bandage is too tight. Remove compression at night.
Elevation – Elevation of the injured ankle above the level of the hip allows gravity to draw the fluid away from the injury. This helps decrease swelling and so can lower pain associated with the pressure created by the excess fluid build up.
Referral – Seek expert advice. The therapists at 4 Life Physiotherapy are experienced in the assessment, treatment and rehabilitation of ankle sprains. Early and appropriate treatment and advice is crucial in obtaining the optimum recovery for your injury and in preventing complications.
No Heat, No Alcohol, No Running, and No Massage in the first 48 to 72 hours. All these will lead to increased swelling and bleeding in the injured area and delay healing.
Ankle sprains are often poorly managed resulting in a high incidence of recurrence. An ankle sprain, even a relatively mild one, when not treated and rehabbed appropriately can lead to weak ankles and a lifetime of recurrent ankle sprains and other overuse lower limb injuries.
Most people tend to believe that their injury has healed once the pain stops. This is not the case. The absence of pain does not mean that your ankle has fully recovered. Muscle imbalances (weak and tight muscles) in the foot, calf, thigh and hips; reduced range of motion (stiffness); excessive scar tissue; and poor proprioception (balance and control) are common consequences following ankle injury when not fully rehabbed. Research has shown that even with relatively minor ankle sprains, inadequate rehabilitation of the injury not only significantly increases your risk of future ankle injury, but also other overuse injuries to the muscles and joints of the foot and leg.
The clinicians at 4 Life Physiotherapy are experienced in the assessment, diagnosis, treatment and rehabilitation of ankle injuries. We not only provide expert treatment for the symptoms of you ankle sprain (pain, swelling, bruising and stiffness), but we develop individual rehabilitation programs tailored specifically to your needs to address muscle impairments, biomechanics, proprioception, and functional and activity specific retraining to return your ankle back to its pre-injury strength and flexibility. This leads to reduced recovery times, less complications, and reduces your risk of re-injury.
When necessary the Physiotherapists at 4 Life Physiotherapy can also organise referral for imaging of your ankle through x-ray, ultrasound or MRI to assist with the diagnosis of your injury.
So for comprehensive assessment, diagnosis, treatment and rehabilitation of your ankle injury call the experienced team at 4 Life Physiotherapy today.