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Ankle Sprain Physio

Ankle sprains are actually very common foot and ankle injuries that occur when the foot twists or turns beyond its normal range of movement, causing the ligaments of the ankle to overstretch or tear - it's also one of the painful conditions that we treat in our physio clinics.

In America, it's estimated that about 23000 ankles are sprained every single daily. Just in the area of sports injuries, 45% are attributed to ankle sprains. Often, it's basketball players that sprain or injure their ankles.

Generally across the board, patients who are at higher risk of spraining their ankle are:

• younger athletes
• police officers, army/military
• individuals who are active and frequently jumps, runs and changes directions quickly especially doing an athletic activity
• dancers
• etc

What our senior physiotherapists aim to do is help patients with ankle sprains

• reduce their pain
• regain their ankle strength, motion, and balance
• return to normal activity levels (ie 100% return to normal life and sports)
  
• avoid ankle reinjury

What Is an Ankle Sprain?

Ankle sprains are injuries to ligaments (the bands of tissue that hold joints together) in the ankle, and they happen when the patient's foot twists or turns beyond its normal range of movement, causing the ligaments connecting the bones of the leg, ankle, and foot to overstretch and/or tear.

Most of the time, it is the ligaments on the outer (lateral) side of the ankle that are commonly injured. Ankle ligaments on the inner (medial) side or above the ankle bone can also be sprained, but they tend to be injured less frequently.

An ankle sprain usually takes between 4 weeks to 2 months to heal.

Most patients will report that their ankles feel better after 3-4 weeks, and can usually be fully strengthened within 3 months. That being said, a badly and severely strained ankle ligament can take 9-12 months to recovery fully, with physiotherapy.

Unfortunately, patients who had ankle sprains before tend to have reinjury (termed as "recurrent ankle sprains") and this happens up to 73% of the time according to statistics. What happens is that once an ankle ligament is sprained, it is often reinjured because of unresolved residual damages that requires ankle physiotherapy to restore and rehabilitate.

Ankle sprains and reinjuries is especially likely if ankle muscle strength and balance are not fully restored to, or improved beyond, preinjury levels.

How Does an ankle sprain Feel like?

Right after an ankle sprain, you may experience:

• Pain
• Swelling
• Inability to step, stand, bear weight or even walk on the affected foot
• Throbbing
• Stiffness
• Weakness
• A feeling of instability in the ankle joint

After most ankle sprains, you will feel pain right away at the site of the ligament stretch or tear.

Often, the ankle starts to swell immediately and may bruise (blue-black). The ankle area usually is tender to the touch, and the moment you move, put weight or step on the ankle, it will have a sharp pain.

In more severe ankle sprains, you may hear or feel something tear, along with a "pop" or "snap" sound.

How are ankle sprains Diagnosed?

If you see our senior physiotherapists first, they will examine your ankle, take your health history, and ask questions such as:

• How did you get injured?
• Did you feel a pop, snap, or tear?
• What activities are you having trouble doing?
• What activities do you want to get back to doing?

They will gently press and palpate around your ankle to see if it is painful to the touch, and may use additional tests to determine if other parts of your foot are injured. They will also

• test your strength and flexibility
• observe how you can move your foot and leg and
  
• observe how you walk

Depending on how badly your ankle ligament is damaged, or how many ligaments are injured, your ankle sprain may be classified as:

• Grade 1 (mild). The ligament is overstretched.
• Grade 2 (moderate). The ligament is overstretched or partially torn.
• Grade 3 (severe). The ligament is completely torn (100% ligament rupture).

Our senior physiotherapist also will test and screen for other, more serious conditions that could be causing the pain and swelling.

To provide a definitive diagnosis, they may collaborate with an orthopedic doctor or other health care provider, who may order further tests, such as an x-ray, to confirm the diagnosis and to rule out other damage to the ankle, including a possible ankle fracture.

How Can our senior PhysioTherapists Help?

Our senior physiotherapists help patients with ankle sprains recover more quickly than they would without treatment. The time it takes to heal an ankle sprain varies, but results can often be achieved in 2 to 10 weeks. We will work with you to design a specific treatment program that meets your specific needs and goals.

During the first 24 to 48 hours following your diagnosis, our senior physiotherapist may advise you to:

• Rest the area by avoiding any activity that causes pain.
• Cold therapy ice packs to the area for 15 to 20 minutes every 2 hours.
• Consult with an orthopedic doctor for further services, such as medication or diagnostic tests.
• Walk on the affected foot as soon, and as much as you are able, without making the pain or swelling worse.
• Use crutches or other walking aids to help alleviate pain and support balance.
• Wrap your ankle or use an ankle brace for support and to prevent swelling.

These self-treatments will allow you to be as active as possible with the least amount of pain, and will help speed healing.  

We will also work with you to:

Reduce Pain and Swelling. You will learn how to avoid or modify your daily and sports activities to allow healing to begin. We may use different types of treatments and technologies to control and reduce your pain and swelling, including

• cold therapy
• heat therapy
• ultrasound therapy and radio-frequency Indiba physiotherapy to accelerate ligament healing
  
• electrical stimulation
• taping
• specific exercises
  
• hands-on therapy, such as manual therapy and specialized massage

Improve Motion. We will choose specific activities and treatments to help restore normal movement in the ankle. These might begin with "passive" motions that the we perform for you to gently move your ankle and foot, and then gradually progress to “active” exercises and stretches that you do yourself.

Improve Flexibility. We will determine if any foot, ankle, or lower leg muscles are tight, begin to stretch them, and teach you how to stretch them.

Improve Strength. Ankle sprains may be related to weak, injured, or uncoordinated leg muscles. Certain exercises will aid healing at each stage of recovery; we will choose and teach you the correct exercises and equipment to use, to steadily and safely restore your strength.

These may include using

• cuff weights
• stretch bands
• weight-lifting equipment

Improve Endurance. Regaining your muscular endurance in the ankle and leg is important after an injury. We will teach you exercises to improve endurance, so you can return to your normal activities. Cardio-exercise equipment may be used, such as

• treadmills
  
• stationary bicycles

Improve Balance. Regaining your sense of balance is important after an injury. We will train and teach you exercises to improve your balance ability.

Restore Agility. Speed and accuracy of leg movement is important in athletics and in many daily activities. We will help you regain these skills in preparation for a return to sports and to your daily routine.

Return to Activities. Your physical therapist will discuss activity goals with you and use them to set your work, sport, and home-life recovery goals. Your treatment program will help you reach your goals in the safest, fastest, and most effective way possible. Your physical therapist will teach you exercises, work retraining activities, and sport-specific techniques and drills to help you achieve your goals.

Speed Recovery Time. Your physical therapist is trained and experienced in choosing the best treatments and exercises to help you safely heal, return to your normal lifestyle, and reach your goals faster than you are likely to do on your own.

If Surgery Is Necessary

Surgery is not commonly required for ankle sprains. But if surgery is needed, you will follow a post-surgery ankle physiotherapy recovery program over several weeks, guided by our senior physiotherapist. We will help you

• minimize pain
• regain motion and strength
• return to normal activities in the safest and speediest manner possible

how to prevent ankle sprains

We can recommend a home-exercise program to help prevent ankle sprains which may include

• strength
• flexibility
• balance exercises

If you have sprained your ankle once, it is at greater risk for reinjury in the future, so if the ligaments did not heal properly or if your ankle never returned to its normal strength. And if you return to sports or other activities too soon after injury, your ankle might give you persistent pain or might easily or frequently reinjure.

Possible other factors that may increase someone’s risk of spraining an ankle are body weight, female gender, muscle weakness, balance problems, or foot/ankle problems.

To help prevent an ankle sprain or a reinjury, we recommend that you:

• Warm up effectively before any sporting/athletic activities
• Use appropriate footwear that is best for specific activities.
• Use ankle wraps or braces as directed
• Perform specific balance and strength exercises several times per week for up to a year
• Maintain a healthy body weight