Ankle Sprains? Do Not ignore Proper Rehabilitation
Updated: Apr 3, 2019
Have you ever “twisted” or outright sprained your ankle? Most people have so you’ll know how incredibly frustrating it is to limp around for a few weeks, or in a severe case, require crutches / walking boot to just do minor activities of daily living.
An injury like this lends a whole new perspective on ability to walk “normally”.
Ankle injuries are one of the most common injuries of the lower leg and the most common area for recurrent injuries as cited in a 10-year study of high school athletes(1). The long-term implications of these injuries were discussed recently at the International Ankle Consortium, noted that inadequate management of ankle injuries is a “significant global healthcare burden”(2) .
Part of the mismanagement of ankle sprains is that many people simply do not consult with a therapist for assessment and proper treatment, thereby becoming one of a large percentage of people who unnecessarily re-injure their ankle soon after the initial insult, adding weeks, if not months, to the rehabilitation process.
"Neglect now can lead to problems for a very (very) long time."
Recently we had an exceptionally fit 66-year old man present to our office for this very issue. A number of years ago he experienced the original sprain. He didn’t do any treatment at the time. Now he has had a number of sprains in rapid succession. For him, like anyone, this situation is a huge impediment to his normal lifestyle. This time around however, he immediately consulted with our physiotherapist about a rehabilitation regime, who also involved our foot specialist about orthoses. With this tag-team approach, his chances of a much more rapid and sustained recovery are greatly improved.
If you are amongst the high percentage of people who unfortunately sprain an ankle here are the action steps;
Immediate Goal- Control Swelling with MICE!
1. Movement (gentle)- with your foot off the ground, gently move the foot from the ankle joint in pain-free directions, slowly and carefully.
2. Ice- crushed ice in a plastic bag then wrapped in a wet towel should be applied in a 10 minutes on- 10 minutes off – 10 minutes on fashion every few hours
3. Compress- the swollen ankle gently with an elastic bandage between icing sessions
4. Elevate- your foot to at least hip level – you aren’t going anywhere anyway so get that foot up
Once you have “M.I.C.E.” under your belt, what can you do to minimize the risk of this occurring again?
Short to Intermediate Goal- “Ankle-Brain Repair Regime”
1. balance exercises that challenge the brain-foot connection for proprioception
standing on one foot with eyes open and closed
balancing on a wobble board, first with support then progressing to none
2. increasing the pain-free range of motion of the ankle joint and associated muscles
initially with no resistance
adding resistance via bands and PNF stretches
3. weight bearing exercise with advancing levels of dynamic movements
regular walking with attention to any limp
progressively faster walking speeds with some light, short jogs
eventually laterally movements through traffic cones and/or through objects on the floor
4. return to sport/activity at a “participation level”, not full out competition
5. adding kinesiology tape during activities to enhance ankle awareness
This process can take at least 6 weeks depending upon the degree of sprain.
Depending upon your level of sport or demands at work, employing a trained therapist to walk you through (literally) this long, and sometimes frustrating rehabilitation, is time and money well spent.
“Pay now and play sooner or play now and pay forever.”
1. Welton KL et al. Injury Recurrence Among High School Athletes in the United States: A Decade of Patterns and Trends, 2005-2006 Through 2015-2016. Orthop J Sports Med. 2018 Jan 2;6(1)
2. Gribble PAet al. 2016 consensus statement of the International Ankle Consortium: prevalence, impact and long-term consequences of lateral ankle sprains. Br J Sports Med. 2016 Dec;50(24):1493-1495.