A sprained ankle – we’ve all had one, but did you do the right thing at the time to ensure it healed properly? If not healed properly it can so often lead to on going foot and ankle pain. 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, if you’ve sprained your ankle in the past, it is more susceptible to re-injury in the future and thus this leads to foot and ankle pain. This is because we bear a significant amount of weight through this joint. Thus, when you roll over it, the force transmitted through the ligaments is so great that their tensile strength is weakened considerably. Ligaments are the structures that hold to 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 – can be caused by walking or jogging, resulting in a trip or fall and leading to a rolling of the ankle. The pain is intense but wears off significantly within 5-10minutes. You might even feel capable of returning to the activity you were doing, you may be forced to limp, and there is moderate swelling, usually with little to no bruising around the ankle.
REALLY BAD – caused by running or sprinting, followed by a trip, fall or tackle. High speed movements is always a factor as well as possible excessive twisting on a grounded ankle such as in kicking a football. A ‘snap’ sound may be heard denoting a tear through one or more ankle ligaments. The incident brings the person to the ground in agony with severe pain. Weight bearing is not possible, there is significant swelling and terrible bruising around ankle and base of foot over the next 24-72hrs.
So what should one do when one rolls an ankle, regardless of severity?
1.Follow the R.I.C.E protocol to alleviate ankle and foot pain
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 currently in debate as to whether icing in fact helps (reduces inflammation) or retards healing soft tissue injuries. You can read further information by searching, “Debunking the Ice Myth.”
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 foot and 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.
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 wont be moving to the same degree as prior to your injury, its 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.
Soleus stretch/Gastocnemius/Flexor hallicus longus stretch (first piture below). Gentle ATFL stretching (second picture below). Finally, using a towel placed around the base of your foot (like a stirrup), hold each end of the towel with your hands, then pull your foot 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.
*DISCLAIMER: This discussion does not provide medical advice. The information, including but not limited to, text, graphics, images and other material contained in this discussion are for informational purposes only. The purpose of this discussion is to promote broad consumer understanding and knowledge of various health topics. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read in this blog.