Ankle Sprains are among the most common of all sports-related injuries. The ankle joint is designed to adapt to uneven terrain, but a sudden or forceful twisting motion can result in damage to the ankle ligaments and in severe sprains, the ligaments can be torn.
The most common ankle sprain is an inversion ankle sprain where the ankle turns over so the sole of the foot faces inwards, causing the ligaments on the outside of the ankle to stretch beyond their limit.
If there is repeated ankle sprains, severe damage to ankle ligaments or poor rehabilitation after an ankle sprain then chronic pain and instability can result. This is why injury rehabilitation and the proper treatment following an ankle sprain is essential not only to reduce your pain and discomfort but to prevent long term problems.
There may be pain, stiffness and swelling around your ankle, and you may not be able to put any weight of it. There may or may not be bruising that can extend down your foot towards your toes.
If you think you have sprained your ankle:
1. Follow the RICE Protocol (Rest / Ice / Compression / Elevation)
2. Seek Medical Attention ( your doctor / chiropractor will assess your ankle and will most likely refer you for an X-ray to assess the integrity of your ankle.
If you have a mild to moderate ankle sprain you may be advised pain relief medication / anti inflammatories and advised to use crutches with the RICE protocol until the injury is healed. If severe then you may be referred for surgery.
For a mild to moderate ankle sprain this can occur relatively quickly following the injury to help reduce pain and discomfort and speed up recovery.
In the early stages you will be recommended various treatment modalities, manual therapy and soft tissue release to help promote healing and rehabilitation. Furthermore, Pain Free Ankle Range of Motion Exercises will be advised, ie, writing the alphabet using your big toe as the pointer. Perform this frequently during the day until full Range of Motion has returned. In addition, pool walking can be began building up to deep- water pool running.
Once you can demonstrate full weight bearing with minimal swelling, with a difference of 1-1.5 cm between each ankle you can begin the following rehabilitation program.
EXERCISE 1- Roll Plantar Fascia (60sec each foot)
EXERCISE 2 – Foam Roll Calves and Peroneals ( 2-3 minutes per leg)
EXERCISE 3 – Ankle Mobility Drill
Stand with feet facing wall.
Place weight on heel and bend knee towards wall without heel rising.
Move foot further from wall as you get better.
Should be able to get 4 inches from wall with the knee touching the wall and heel on the floor.
Do 10 reps each foot.
EXERCISE 4 – Eccentric Calf Stretching ( 10 reps x 2 sec hold in each stretch)
Stand on a step.
Raise up using two feet.
Take one off and lower to position B – hold for 2 seconds. Then bend knee to position C – hold 2 seconds.
Put other foot back on step and raise to top position. Repeat 10 times per side.
EXERCISE 5 – Ankle Inversion and Eversion Strengthening (15-20 reps per side)
EXERCISE 6 – Ankle Dorsi Flexion Strengthening (15-20 reps per side)
EXERCISE 7 – Single Leg Stands ( as pain allows – 30 seconds each leg)
EXERCISE 8 – Walking until you can jog pain free.
RETURN TO SPORT
Before returning to sport you should be able to demonstrate:
– no swelling
– participate in Warm- ups with no discomfort ( strapping your ankle as required) – complete high level running at distances relevant to your sport without pain
– ankle flexibility within 10% of the other ankle
– complete single vertical and horizontal hops and plyometric drills without pain – participated in full training for at least 1-2 weeks.