What is an ankle sprain?
Your ankle is a complex joint between your leg and foot made of multiple ligaments. These, like all ligaments in the human body, provide stability, send information to your brain, and direct how your joint moves. An injury in one or more of these ankle joint ligaments is exactly what an ankle sprain is.
Ankle sprains happen more often than you think. Accounting for 50% of all sport-related injuries and 25% of all musculoskeletal injuries, ankle sprains from an excessive inversion or lateral rolling of the foot combined with external rotation are the most common injury in sport and occur in 1 in 10 000 people a day.
The lateral side of your ankle is each made of 3 ligaments that help keep them stable: your anterior talofibular ligament (ATL), your calcaneofibular ligament (CFL) and your posterior talofibular ligament (PTFL). Inversion injuries typically cause damage to these lateral ligaments.
The greatest risk factor for an ankle sprain is a previous ankle sprain. Recurrent ankle sprains and repeated ligamentous injuries may result in joint instability, loss of normal ankle control, increased risk of long-term degeneration, and chronic pain.
How do I know if I have an ankle sprain?
Common signs and symptoms of acute ankle sprains include:
- Difficulty bearing weight
- Significant swelling
- Ecchymosis (discolouring of the skin or bruising)
Pain is usually found around the lateral (out) side of the ankle. Frequent complaints in more severe ankle sprains include joint instability, stiffness, and intermittent swelling.
How do I treat my ankle sprain?
Ankle sprain treatment involves 2 stages: (1) Acute Treatment and (2) Functional Rehabilitation:
1. Acute Treatment
Acute Treatment focuses on minimizing swelling in and around the ankle joint, controlling pain, protecting from further injury, promoting healing, and limiting long-term deficits in strength, flexibility, and endurance.
An acronym used for acute treatment of ankle sprains and most other musculoskeletal injuries is RICE:
R – Rest the injured body part
I – Apply Ice
C – Apply compression
E – Elevate the injured extremity above heart level.
Rest is usually required for two to ten days and varies from absolute rest (not moving the injured body part at all) to relative rest (minimizing mobilization) depending on the severity of the injury.
Ice reduces swelling and decreases pain, however, should never be applied directly to the skin or for longer than 15 – 20 minutes.
Compression is usually with a bandage wrapped tight enough to reduce swelling, but not so tight that it restricts blood flow.
Elevation helps drain excess fluid to the heart.
2. Functional Rehabilitation
Functional Rehabilitation involving early mobilization and external support is necessary after acute treatment as it improves joint stability, function, and strength, reduces the risk of ankle giving way, helps restore range of motion, and prevents re-injury in weeks following the sprain.
Although it may be tempting to jump right back into normal exercise after pain and swelling pass, lack of proper rehabilitation places the patient at a higher risk for future ankle and chronic functional instability.
The range of motion exercises that practice moving the ankle in different directions along with higher levels of stress strength exercises and neuromuscular training all help improve strength and balance and often lead to full functional recovery.
Great examples of these exercises include:
- Ankle pumps
- Ankle inversion
- Ankle eversion
- Calf raises
- Wobble board activities
- Hop to stabilization exercises
- Single-limb stance balance activities
For more details on how to perform these and other ankle stability exercises feel free to give this video a look!
The article and video is meant solely for informational purposes only. If you have any additional questions or concerns, please consult with your health care provider, or book an appointment with one of our physiotherapists.