How to treat your ankle sprain
To understand an ankle sprain it is important to look at the ankle joint and how it gains its stability. The ankle is a joint that is formed by the tibia and fibula (shin bones) and the talus (bone of the foot). The arrangement of these bones, along with the ligament surrounding the joint is what helps the ankle stabilise during activities such as walking, running and playing sport.
Instability to the ankle can therefore develop if there is injury to the bones (i.e. a fracture) or the ligaments (i.e. an ankle sprain).
We have ligaments on the inside and outside of the ankle joint and the extent of instability after a sprain is dependent upon which one of these is injured and the extent of the injury.
An ankle sprain is commonly seen in physiotherapy and occurs when one or more of the ligaments are stretched and/or torn. This occurs by the foot being rapidly turned inwards or outwards which over stretches the ligaments on the side of the ankle.
In the early stages, pain and stiffness often arise due to an increase of blood and swelling in and around the ankle. Minimising swelling helps the ankle heal faster, with most sprains healing completely within a few weeks if the swelling is managed well and the grade of the sprain is mild.
Here are the most effective ways to do this…
The initial goal immediately after an ankle sprain is to decrease post-injury swelling, bleeding and pain. It is also essential to protect the healing ligament(s).
Ligaments must be maintained in a stable position in the early stage so healing can occur. This can be achieved with ankle strapping by your physiotherapist, the use of a brace support and / or using elbow crutches to take some of the weight off the injured ankle. Early walking is recommended as soon as pain allows to ensure the Achilles tendon does not tightness.
Allow your injured ankle to rest for approximately 1-3 days after the injury. Caution should be taken against vigorous exercise, however exercises for the uninjured leg can be performed.
Ice the ankle every two hours for 15- 20 minutes to decrease pain and swelling for the first 48-72 hours. Do not place ice directly on to the skin and do not use for over 30 minutes at a time.
Use ankle brace, strapping or a bandage to provide both support and pressure to the area to help decrease the swelling.
Elevate as much as possible with the foot higher than the waist to reduce swelling and pain. To get the most from the elevation we would also recommend moving the foot up and down in a brisk manner to help swelling move away from the injured site.
When do I need to come and see a Physiotherapist?
Most ankle sprains will improve and resolve within 3-6 weeks however we would recommend you come and see one of the team if:
– You are concerned about a high-grade tear
– You are struggling to reduce your swelling
– Pain is continuing past 3-4 weeks
– Your ankle is giving way when you stand / walk
– You are having recurrent sprains
What will the physiotherapist do?
The physiotherapists will firstly need to physically assess your ankle to diagnose which ligament(s) have been injured and to what extent. They will also look at the overall function of the ankle and where pain may still be arising from. Treatment will then be tailored to your specific needs and often includes:
– Ankle mobilisation to overcome joint stiffness
– Massage over the calf and Achilles tendon (particularly if you have struggled to weight bear after your injury)
– Deep frictions over the ligament to re-boot healing processes
– Exercises to help strengthen the ankle and restore stability
– Bracing advice for sport
The physiotherapist may feel that further investigation or Orthopaedic assessment is required if they suspect a complete rupture of the ligament or a bone injury such as a fracture.
If you are unsure whether your sprain needs physiotherapy treatment, why not call us today to discuss with one of our team at Covent Garden or Marble Arch on 020 8901 6545 or email us at [email protected]