It’s Only An Ankle Sprain!!

Ankle sprains are the most common foot and ankle injury.  They are the most common sport related injury although only 40% of them occur during sports.  The frequency with which ankle sprains occur means that people often do not seek any medical attention or get help with their rehabilitation because it is ‘just an ankle sprain’.  How do you know when to get help for your ankle sprain?    Where should you go for help?

Seek medical attention in urgent care when;

1. You were unable to take any steps on that side after your injury and had to be helped off the field or into a car.
2. You couldn’t take any steps immediately after your injury and you have acute tenderness on the ends of the tibia and fibula (the prominent bones at your ankle joint on either side). There also may be tenderness in the lower 6 cm of the fibula or tibia, or on the prominent bone up from your 5^th toe (base of the 5^th metatarsal) or on the bump on the inside of your foot (navicular).

This is from the Ottawa Ankle Rules and are all indications that you need an x-ray to rule out a fracture of any of these bones.

If you feel your sprain is a mild one;

1. Ice the ankle over the swollen or tender area for 10-15 minutes once every 2-3 hours during the day. When the ice if off wrap it in a tensor bandage, wear a brace, or have it taped for the compression to control swelling.
2. Keep your ankle moving! Do range of motion exercises throughout the day.  You do not need to push into pain but the comfortable range should gradually increase.
3. Walk on it as much as is comfortable without increasing the swelling. You may need to use crutches to partially weight bear for the first couple of days but if you need to use them any longer you should make a physio appointment for assessment as this is not a mild sprain.

Seek an assessment from your physiotherapist when;

1. You do not have a fracture but you have significant swelling and weightbearing is painful.
2. You cannot comfortably walk on the foot and ankle after 3-5 days.
3. You would like a thorough assessment of your ankle and foot to determine what the best course of action is for you to recover in the best way possible.
4. This is a recurring problem for you.

Why is my ankle important to my function?

The ankle joint and the joint below it, the subtalar joint, act together to transfer load both from your body down into the ground and from your foot up into your body.  Their ability to work together influences what muscle activity will occur not only in the foot and leg but throughout your body.  Sounds complicated?  The main take away is that the movement and stability of the ankle and subtalar joint are very important for the muscle function throughout your body so we need to take care of the foot and ankle to allow us to function well.

Why do I need to have physiotherapy for my ankle sprain?

We now know that other structures as well as the ligaments can be injured during the incident and that there is a high level of recurrence of sprains. The recurrence of sprains is attributed to loss of strength of the muscles around the ankle, the leg and the hip, loss of mobility at the ankle and foot, and a change in the timing of muscle activity in the ankle, leg and hip.  Despite the level of recurrence of sprains only 7-11% of those seeking medical attention are referred for physiotherapy.

Physiotherapists are trained to assess the mobility and stability of the joints around your ankle as well as your balance and ability to move efficiently.  We can design a program for you to get the best possible recovery from your ankle sprain.  We can get help from our team of Kinesiologists for specific higher level programs for your return to play.  Our clinical pilates team can help you improve your movement patterns.  We are here to work with you to get back into the game, whatever that is for you.

Written By: Deb Treloar