So there is a strong chance if you are reading this blog then you have recently sprained your ankle! If so then you have come to the right place, and yes, before we begin, it’s a very painful thing to do so you have our deepest sympathies.
The good news is that if managed properly, you can recover quite quickly from these type of injuries and get back to doing kick-flips on your skateboard, or playing football with your friends in no time.
Ankle sprains occur when the outside of the foot is forced down and under the foot. This stretches the ligaments supporting the outside of the ankle.
In normal day to day activity most people sprain their ankle by stepping down or slipping from the edge of a kerb. In sporting situations, its usually when you change direction quickly and your ankle folds under you as your body weight shifts over the outside of the foot. The injury is most commonly found with the Anterior Talofibular Ligament although the Calcaneofibular Ligament can be injured also.
You will usually feel a sharp pain and often a popping sound or feeling. This is followed soon after by a sensation of the ankle swelling up and a pressure building around the ankle joint. Sometimes, there might be bruising around the ankle. It’s quite an unpleasant experience and can sometimes feel like the ankle is going to explode!
Firstly you should look to see if there is any visible deformity to the ankle or foot. Compare how it looks with your uninjured side. If there is a difference, then you need to be seen at the hospital as there is a strong likelihood that you have a fracture.
If this is the case, keep your ankle still, and avoid walking on it. Someone with first-aid experience can try to splint it in place until you get assessed at the hospital.
If there are no obvious deformities, then try to see if you can move your ankle around.
If you can, then that’s good news. Next, try taking a few steps on your injured ankle – walking on tip-toes or your heels is acceptable. You might need help but if you can do this, then we can be pretty confident that there isn’t a fracture. If you are unable to put any weight through your foot, then it will be wise to get yourself seen at the hospital.
*Fractures sometimes happen in the same manner as an ankle sprain so it is incorrect to assume every ankle injury is an ankle sprain. When in doubt, consult a qualified health professional.
The next thing you should try to follow is the POLICE guidelines.
P – Protect
Protect the ankle from further injury. This means that you stop the movements that makes the pain worse for the next few days at least. You can expect things to calm down and start feeling better within the next 72 hours.
OL – Optimal Loading
Once the pain and swelling has settled down a bit, you will need to start gradually loading the ankle. This is because complete rest or immobilization does not help ligament injuries to heal quicker, and in fact, might slow down the recovery process.
A simple way to do this is to make sure you walk with a normal heel-toe walking pattern as much as you can tolerate and avoid limping on tip-toes or the heel.
Additionally, follow this set of basic range of motion exercises to help return ankle’s mobility to normal. Do these 4 times per day for 3 sets of 10-20 reps as able.
1. Point your toes and ankle up towards you and then point them away
2. Turn the sole of the foot inwards and then turn it outwards
3. Rotate your foot clockwise and then in a counter-clockwise direction
4. Knee to wall stretch – see the exercises below
*Some discomfort and stiffness is expected. If these exercises causes significant and lingering pain, stop and consult a qualifed health professional.
I – Ice
Ice the painful area for 10-20 minutes several times per day for the first few days. This is to help with pain and control inflammation. You can stop when the pain settles.
C – Compression
Compression devices such as tubigrips will help support the ankle and minimise the inflammation. Take them out if you feel your feet or toes become numb and tingly – this indicates that circulation is compromised. As a rule, don’t wear the compression garment or tubigrip whilst you sleep to avoid affecting blood circulation.
E – Elevation
In the first few days of the injury, try to keep your ankle above your hip whenever you are not moving about. You can place a few pillows or towels under your lower leg. This will help limit the swelling in the ankle. Often placing a few pillows under your lower leg is ideal.
After around 7-10 days the ankle should start to feel quite a bit better. At this stage, we need to start loading the ankle with more specific exercises to restore the function of the stabilising muscles and balance sensors. This is to minimise the risk of a recurrent sprain in the future.
Here are some exercises you can try. Follow the instructions in the descriptions.
2. Single Leg Heel Raise
3. Single Leg Balance
For the most part, these exercises should be sufficient to get your ankle to where it needs to be for your day to day needs. But if you have been more active pre-injury, it is a good idea to continue with further rehabilitation to meet the demands of your sport – the demands of a footballer and skateboarder are very different!
At ESP Physio, we perform a detailed assessment to identify any issues after your injury. We will design a customised treatment plan involving both hands-on work and rehabilitative exercises to get you back on track.
If you would like to make an appointment (or if you just want to speak to us), give us a phone at 01324 227 370 or drop us an email at firstname.lastname@example.org.
Written by Lewis Mitchell and Andrew Linn