Action points for treating ankle sprains (sprained ankle).
A sprained ankle, weve all had one, but did you do the right thing at the time to ensure it healed properly? There are an infinite number of ways to sprain an ankle. This article focuses on the most common mode of onset where there is a rolling over motion of the ankle joint. During this motion, the anatomical structure most at risk is the anterior talofibular ligament, which may tear partially or completely.
Annoyingly with ankle sprains, if you’ve sprained your ankle in the past, it is more susceptible to re-injury in the future. This is because the ankle is such a weight-bearing joint, and when you roll over it, the force transmitted through the ligaments in particular, is so great that their tensile strength is weakened considerably. Ligaments are the structures that hold two bones together at a joint. They do have some elastic properties but if stretched beyond a certain point and for too long a time, they will stretch or tear to a point beyond return. Thus, when a joint is dislocated it is vital that it be set immediately to avoid permanent disruption of the surrounding ligaments. Similarly, when you sprain an ankle, there are certain vital steps to follow to avoid further damage to the ligaments. The severity of the sprain will greatly determine the best approach to caring for your sprained ankle. Ankle sprains can be categorised into two [extremely broad] categories: bad or really bad.
BAD: walking or jogging resulting in a trip or fall, causing you to roll your ankle, the pain is intense but wears off significantly within 5-10minutes, you may feel capable of returning to the activity you were doing, you are forced to limp, moderate swelling, with usually little to no bruising around the ankle.
REALLY BAD: bad ankle sprains caused by running or sprinting, followed by a trip, fall or tackle. High speed movements is always a factor; possible excessive twisting on a grounded ankle (such as in kicking a football); usually a snap sound is heard denoting a tear through one or more ankle ligaments; the incident brings the person to the ground in agony; severe pain; weight bearing is not possible; significant swelling; terrible bruising around ankle and base of foot (24-72hrs).
So what should you do when you roll your ankle, regardless of severity?
1. Follow the R.I.C.E protocol
Rest – this is very important, your ankle has recently experienced trauma and needs time for the natural healing process to take place. Do not ask too much of your ankle within the first 3 days of injury, thereafter, perform light duties only, up to a period of one week after injury. If your ankle feels sore or tired, regardless of how long it has been since your injury, rest it.
Ice – You can try icing your ankle immediately after an injury for pain relief. It is still in debate as to whether icing in fact helps or retards the healing of soft tissue injuries.
Compression – wrap a bandage around your ankle starting from just above your toes, to above your ankle. The idea here is to encourage movement of the swelling fluid out of the ankle region. Caution: be sure to wrap the ankle in such a way that you don’t trap or push swelling in the toes, if this is too difficult, consider using a reasonable tight sock or stocking, or instead leave compression out entirely and resort to elevation.
Elevation – keep your ankle elevated as often as possible within the first three days of injury also to encourage movement of the swelling fluid out of the ankle region.
2. Exercises
Alphabet writing – write the alphabet with your ankle. This exercise serves to get the ankle moving in different directions. The movement will encourage swelling out of the ankle area and start getting your ankle used to moving again.
Stretching – stretch your calves, this is hugely important, as you won’t be moving to the same degree as prior to your injury, it is vital that you keep your calves as flexible as possible. In this way, these structures are less likely to injure when you return to normal activity.
There are other more specific exercises you can do to rehabilitate your ankle injury.
Picture (left): Soleus stretch/Gastocnemius/Flexor hallicus longus stretch.
Picture (below): Place a towel around the base of your foot (like a stirrup), and hold each end of the towel with your hands. Pull your foot up towards your chin whilst keeping the knee straight (dorsiflexion). This movement serves to increase range of motion in this direction and simultaneously encourage the movement of swelling out of the ankle.
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