Ankle Sprains: What You Need To Know

 

ROLLED ANKLES SUCK RIGHT?!

Having a rolled ankle CONSTANTLY interfering with your sport season or physical activity sucks even more!

 

Have you had a problem with repetitively rolling your ankles?

 

Maybe you’re the person in your group who’s always had WEAK ANKLES?

Ankle Sprain

Having a rolled ankle CONSTANTLY interfering with your sport season or physical activity sucks even more!

 

Have you had a problem with repetitively rolling your ankles?

 

Maybe you’re the person in your group who’s always had WEAK ANKLES?

 

If you’re answering yes to either of those questions, or you’ve just done it for the first time, then read on!

 

 

 

Lateral Ankle Sprain – What Is It?

 

The most common type of rolled ankle is called an inversion ankle sprain or lateral ankle sprain. It often occurs when landing awkwardly on an uneven surface or an object, turning the foot to face in and stressing the ligaments that support the outside of the ankle.

Ligament Sprain Grades

 

A rolled ankle or ankle sprain is graded on severity:

           Grade 1 = mild sprain

           Grade 2 = moderate sprain with microligament lesions

           Grade 3 = severe sprain with full ligament lesion

 

As you probably know by now, ankle sprains can be VERY PAINFUL initially. This is because the ligaments have very high nerve innovation.

 

The ankle ligaments provide passive stability for the ankle joint & provide sensory information back to the brain about positional awareness of the ankle joint – this is called proprioception. More of this later!

 

 

I’ve Just Rolled My Ankle – What Now?

 

Up to 15% of all ankle sprains may suffer a fracture as well! If you’re unable to put weight through your foot due to extreme pain you should seek the assessment of a physiotherapist or GP to determine if an x-ray is warranted.

 

R.I.C.E.-1

You’ve probably heard with all acute injuries you should Rest, Ice, Compress and Elevate (R.I.C.E.)?

 

Well, yes and no.

 

Evidence has consistently showed that R.I.C.E. in isolation leads to poor injury outcomes (Pain, Swelling, and recurrence!), compared to when it is used in combination with exercise rehabilitation!

 

                                                                                                                                                       (Courtesy of Verywell Health)

 

 

What To Do in the First 48-72hrs After an Ankle Sprain?

 

R.I.C.E.

Rest: adjust your activity with pain as a guide, however total rest can be detrimental!


Ice: Apply for 15-20min every 2 hours – make sure you check the skin for ice burns!


Compression: bandage or tubigrip


Elevation: should be above the level of the heart!


BONUS ADVICE: Gentle calf pumps when laying down or seated can assist with reducing swelling!

 

 

 

Do I Need a Brace?

 

Active Control vs Passive Support

If you’re struggling with pain and activity a rigid brace may be useful, however it is recommended to only use a rigid brace for less than 10 days to avoid increasing joint stiffness.

 

When returning to sport a ‘functional’ brace – one that moves – may be useful for 4-6 weeks after the initial injury.

 

However, developing ACTIVE control is ALWAYS better than relying on PASSIVE support!

 

 

 

 

Ankle Sprain Rehabilitation – What and Why?

 

Pain often decreases within the first two weeks. When the pain has settled is when the real rehabilitation begins!

 

Up to 34% of people experience recurrent ankle sprains, and up to 55% report ongoing instability!

 

That’s huge! But it doesn’t have to be you!

 

Get Strong Stay Stronger

After an ankle sprain you will have decreased strength, range of motion, proprioception and postural control that need to be rehabilitated. While the ligaments will heal, you need to retrain these elements!

 

Once range of motion and strength is BETTER THAN PRE-INJURY you should continue to work on your proprioception and postural control for up to 12 months!

 

You read that right, optimal rehabilitation continues for 12 months! This is because the disturbances in proprioception and postural control originate from the central nervous system (brain and spinal cord), which takes time to adapt.

 

 

What to do for Ankle Sprain Rehabilitation?

 

At Paramount Physiotherapy our Optimal Injury Rehabilitation will include (below are example exercises):

 

Ankle Range of Motion


Ankle - Range of Motion               Ankle - Release                             

                                       Mobility Exercises                                                                Release Exercises with Spiky Ball

 

 

Ankle AND Hip Strengthening

         Ankle - Single Leg Calf Raise   Ankle - Deadlift

                                    Single Leg Calf Raise                                                                      Single Leg Hip Hinge

 

 

Activity-Specific Proprioception and Postural Control        

                                                                                                 

  Ankle - Balance Pad       Ankle - Bosu Ball

                             Single Leg Balance on Foam Pad                                                                         Bosu Ball with Ball Toss

 

 

Multi-Directional Plyometrics

    Ankle - Lateral Jump        Ankle - Drop Jump

                                          Lateral Jumps                                                                         Drop Jump from Height with Hurdle Jumps

 



Return to Running Program

        Ankle - Agility          Ankle - Sprint

                                            Agility Work                                                                                         Graduated Sprint Program

Photos supplied by Physitrack

 

The Wrap Up

 

We get it, you just play local sport and just want to play? We’ve all been there before!

 

Be elite, rehabilitate like a pro, then dominate on the weekends instead of sitting on the sideline with an ice bag on your ankle!

 

Mark Walters
Mark Walters
Principal Physiotherapist (APA, DPT) B. Ex. Sci, D. Physio Mark thrives on helping people getting back to the activities they enjoy, and aims to do this with fun and engaging rehabilitation. He also has a passion for injury prevention and performance, as well as helping people age strong.