The Do’s and Don’ts of an Ankle Sprain

Chances are high that you’ve rolled your ankle at least once throughout your life. Ankle sprains are a common but often overlooked injury. This is because, even when not treated, over time the pain will decrease and function will increase. The issue is that without treatment, overall function will not revert back to 100%. The tissue and function is more likely to return to 100% function when treatment is involved. 


The Anatomy: 

The most common ankle sprains are lateral ankle sprains (injuries to the outside of the ankle). There are three main ligaments associated with the lateral ankle sprains. They are the: 

Posterior Talofibular Ligament
Anterior Talofibular Ligament
Calcaneofibular Ligament 

These ligaments run from the bottom of your shin bone to the bones of your foot. Their function is to hold the bones together and provide proprioceptive feedback. Proprioceptive feedback is information of where your joint is in space, which provides your balance and stability. 

The Mechanism:

When you sprain your lateral ankle, your foot rolls in towards the midline of your body. The base of your shin drops to the outside and it pulls on the ligaments that attach your leg to your foot. Ankle sprains can happen while walking or running on uneven surfaces or during slips or falls. 

 

Symptoms and Severity of an Ankle Sprain: 

Symptoms can include any of the following: 

  • Swelling around the joint and into the foot
  • Bruising
  • Difficulty bending or walking 
  • A feeling of instability 

 

Which of these symptoms appear are dependent on the severity of the injury. Typically an increase of symptoms is directly correlated to increased severity of the injury.  

Ankle sprains are graded on a scale of 1 to 3. A Grade 1 sprain has minimal tissue damage and is quickest to heal. Grade 2 is a partial tear and Grade 3 involves a complete rupture of one or more of the ligaments. The higher the grade, the greater the damage and impairment. Impairment for ankle sprains can range from slight pain and no swelling to an inability to bear weight and significant swelling. In Grade 2 and 3 tears bruising may be apparent, but may not appear immediately after the injury. 

 

Ankle Sprain Treatment:

Treatment options for ankle sprains are based on the severity of the injury but are indicated in all sprains. While the treatment may vary it’s important to look at what the goals of treatment are. 

  1. Decrease pain and swelling
  2. Increase non-weight bearing range of motion
  3. Increased stability of the joint
  4. Increase the tissue tolerance 

A variety of different therapy modalities can be used to achieve the best results. A typical treatment regimen can include soft tissue therapy, ankle mobilizations or adjustments, kinesio taping and rehabilitative exercises. When combined these treatments can provide long lasting results that allow you to improve your ankle function, and also prevent future injuries. 

Immediately after spraining an ankle it is important to think RICE.

1) Rest the ankle

2) Ice the area

3) Wear a compression bandage as tolerated 

4) Elevate the foot as much as possible

This combination of rest, ice, compression and elevation can help decrease the acute symptoms that happen directly after the injury. 

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