Managing an Ankle Sprain
Si En Wong, Physiotherapist
Ankle sprains. An injury that happens more often than we would like. Be it from a footy game or walking around in heels. It can be very stressful when you have sprained your ankle and you are unsure of how to manage it. Is further imaging is required? Should you go to the emergency department? Maybe it is not that bad, just sleep on it and it will be fine tomorrow? Where should you begin?
Here are a few tips on where to start:
1) Assess if you are able to put weight through the ankle, is it too painful to walk more than 4 steps?
2) Is it tender along the bony bit of ankle joint on either side?
3) Is it tender 6cm above the ankle joint on either side?
If the answer is “yes” to any of the questions above, go to the emergency department and request for further imaging to be done. This is to make sure you do not have a fracture or other tendon injuries.
If the answer is “no” to all questions above, GREAT! However, you have to start managing the inflammatory process by using the R.I.C.E technique. This is important as prolonged inflammation can delay the healing process.
Take it easy, your ankle just went through something it was not designed to handle. Through resting, you are letting the body repair itself.
This is to help minimise the swelling and should be done up to 4 weeks post injury.
Firm strapping around the ankle will help control the swelling as well as protect the joint by giving it ample support.
This helps minimise swelling and bruising by using gravity to send the blood back towards the heart.
Now that the panic is over, let’s move onto the rehabilitation process.
Rehabilitation is crucial for ankle injuries. As small the injury might seem, it was pretty traumatising for your ankle and its supporting tendons, ligaments and muscles. Without proper management there is a risk of developing chronic ankle instability which also means that there is a higher chance of recurrent sprains and further injuries to that ankle in the future. Hence it is important to see a physiotherapist that can help you through the rehabilitation process and tailor a program to strengthen your ankle to prepare it for the future challenges it may face.
Treatment/management required for an ankle sprain:
1) Pain relief – This nasty sensation limits our activity and function more that we care to admit
2) Slowly re-introduce weight bearing through the ankle once the pain is managed – Especially if there was a fracture or tendon injury
3) Muscle spasm relief – As mentioned before, the muscles have gone through a traumatising event trying to protect the ankle joint. Hence its automatic response would be to tighten and go into spasm. By getting the muscle to relax, it will help with pain relief and improve function.
4) Regain ankle mobility – Same as muscle spasm. The body is trying to protect itself by stiffening up the joint to prevent it from moving into various ranges of movement.
5) Strength training for muscles around the ankle to help with stability and function – By strengthening the muscles around the ankle, it would be able to provide the stability and protection required the next time a similar incident happens.
6) Proprioceptive training – Proprioception is the unconscious perception of movement arising from stimuli within the body itself. This is a crucial part of the rehabilitation process as it will train the body to be able to counterbalance or react to various forces around the joint. This in turns helps with stability of the ankle as well.
At the end of the day, it is always important to have a physical examination done by a physiotherapist.
You can then tailor your ankle management and treatment program together with your physiotherapist to suits your needs.