What to expect during and after an ankle sprain injury?
An ankle sprain commonly occurs during activities requiring rapid changes in direction, especially on uneven surfaces. They often occur in basketball, football, volleyball and netball. The usual mechanism of injury is an extreme combination of turning the foot inwards (inversion) and pointing the foot and ankle downwards (plantar flexion) during weight bearing.
- Swelling around the ankle and foot
- Audible snap or tearing sound at the time of injury
- Pain when walking
When is an X-ray required for an ankle sprain?
- Unable to weight bear after 72 hours
- Excessive Swelling and bruising
- Excessive pain in bony areas
Physiotherapy for a sprained ankle:
Physiotherapy treatment is essential for all patients with a sprained ankle as inadequate rehabilitation can result in a poor outcome with a high likelihood of re-injury. Physiotherapy can accelerate the healing process, ensure an optimal outcome and reduce the likelihood of recurrence.
Treatment may comprise of:
- soft tissue massage and joint mobilization
- ankle taping
- ice or heat treatment
- exercises to improve flexibility, strength and balance
- activity modification advice
- the use of crutches
- biomechanical correction
- a gradual return to activity program
Acute Phase Management (0-72hours)
The aim for the acute phase of injury is to reduce swelling and bruising in the area, by restricting blood flow. This can be achieved by following the RICE method.
Rest: Non weight bearing in first 24 hours if required.
Ice: For first 48 hours, 15-20mins per hour, to restrict blood flow.
Compression: With a support bandage (Fig.2), firm taping or brace. The bandage should be firm, but not too tight as to cause numbness, pins and needles or pain.
Elevation: Keeping the ankle elevated will reduce further swelling.
In the acute phase, AVOID:
Heat therapy or ultrasound
Running or excessive walking
Massage to the affected area
Sub Acute Phase (72 hours – 1 week)
In the sub acute phase, the aim is to promote healing of the ligaments, reduce pain, restore range of motion at the ankle and strengthen the surrounding muscles. The following exercises are commonly prescribed to patients with an ankle sprain. You should discuss the suitability of these exercises with your physiotherapist prior to beginning them. Generally, they should be performed 3 times daily and only provided they do not cause or increase symptoms.
Range of Motion Exercises
Foot and Ankle Up and Down
Move your foot and ankle up and down as far as possible and comfortable without pain. Repeat 10 – 20 times.
Foot and Ankle In and Out
Move your foot and ankle in and out as far as possible and comfortable without pain. Repeat 10 -20 times.
With your hands against the wall, place your leg to be stretched in front of you as demonstrated. Keep your heel down. Gently move your knee forward over your toes as far as possible and comfortable without pain. Hold for 5 seconds and repeat 10 times at a mild to moderate stretch pain-free.
Once the swelling has started to settle it is time to start an accelerated rehabilitation program. It is crucial that you work closely with your physiotherapist through this phase to optimise your outcome and prevent reinjures.
Contact Bodysmart for a Physiotherapy consultation to thoroughly assess any injuries. Appointments can be booked here or by contacting 9481 8708.