One of the most common injuries that family, friends and patients ask me about is a sprained ankle. Most of the questions about ankle sprains center around what to do if you have one and what to do to prevent one.
Ankle sprains can occur from a variety of activities. Often, they occur from sports like basketball and soccer, or activities like stepping off a curb or step and missing your footing. You have probably heard of “inversion sprains” and “eversion sprains”. These refer to which way the ankle “rolls”. An inversion sprain occurs when the lateral (outer) ligaments of the ankle are stretched too far. An eversion sprain is when the opposite occurs – the medial (inner) ligaments are stretched too far.
Sprains are graded according to severity. A grade 1 ankle sprain means over-stretching of the ligament(s). There is no laxity (instability) but there is tenderness and mild swelling. A grade 2 ankle sprain creates a partial tear of the ligament(s) with moderate pain, swelling and bruising. There will be mild laxity of the joint. A grade 3 sprain is a complete tear of the ligament(s) with severe swelling and bruising. There will be considerable laxity, which will make walking very difficult.
So now that we know more about what an ankle sprain is, how do we treat them? It’s as simple as RICE. These are general guidelines for an ankle sprain. If you have specific questions or concerns about your case, ask your physician or your physiotherapist/chiropractor.
Rest – limit walking on the ankle. Crutches can be used to help limit weight-bearing through the leg.
Ice – immediately after your injury and for the first 48 hours. This will help decrease swelling. Never put ice directly on the skin – always put a towel or cloth between the ice and you. Leave the ice on for approx. 10-20 minutes and then leave it off the skin for at least 30 minutes or however long it takes for your foot to return to room temperature.
Compression - a wrap or brace can help to decrease swelling of the ankle/foot and will help with any instability.
Elevation – help swelling exit the ankle by placing the ankle higher than your heart.
RICE is great for acute management of an ankle sprain. Once that phase ends, it’s important to regain strength and flexibility of the ankle. Strengthening the ankle will help to prevent future ankle sprains. Balance and proprioceptive training will also help.
Isometric exercises are a great place to start for strengthening your ankle as they involve resistance training without moving the joint/ligaments. This can be done for plantar flexion, dorsiflexion, eversion and inversion. Each exercise should be held for 10 seconds and repeated 10 times for each position.
As a progression, resistance bands or tubing can be used to strengthening the ankle through its range of motion. Again, plantar flexion, dorsiflexion, eversion and inversion should all be included. Start with 10 reps and 1 set for each position.
Balance training is also vital in ankle rehabilitation and prevention of injury. Start simple and progress as you improve. A great place to start is with standing on one foot. Stand on the injured side (that’s the side you want to improve) and, with your eyes open, try to balance without needing to put your other foot down. Your goal is to reach 60 seconds of uninterrupted balancing. Once you’ve done that, you can progress to more challenging exercises. Feel free to train both ankles, even if you’ve only ever injured one. The exercises will help to prevent an injury even if you haven’t had one before.
If you’ve recently experienced an ankle sprain and you are still experiencing pain or instability or if you want to discuss rehabilitation strategies and exercises, I’d love to hear from you. Feel free to call the clinic (902-444-1990) and book an appointment or shoot me an email (ledwards@stradahealth.com).
In the words of Body Break, keep fit and have fun!