The do’s and don’ts of an Ankle Sprain

Ankle sprains are everyday occurrences that commonly take place in sports or other leisure and recreational activities. The ankle joint is supported by medial and lateral ligaments (inner & outer respectively) and is designed to adapt to uneven terrain and awkward landings but may become injured following a sudden twist or fall. Such incidents may lead to a ligament sprain (tear/rupture) or in severe cases, a fracture or dislocation.

Method of onset:

The most common injuries are normally associated with the lateral ligaments that may sprain following a forceful twist of the ankle inwards as the foot strikes the ground. This may cause the ligaments to tear as they overstretch beyond their limit. If the ankle joint is overstretched outwards, the injury is normally associated with the medial ligaments. Ankle sprains are common in day to day activities such as walking downstairs, falling off the edge of a kerb or mis-placing the foot whilst walking. Sprains are more common amongst sports and leisure activities that involve running, walking and jumping on uneven terrain. Lower limb biomechanical implications and poor footwear may also be one of the underlying causative factors to the problem

Symptoms & Diagnosis:

Pain, swelling and bruising are the most common symptoms associated with an ankle sprain. The degree of the symptoms will vary depending on the extent of the sprain from mild to severe. In more severe cases, walking will be difficult and weight bearing on the ankle may be problematic.


Early Management:

For the first couple of days follow the 4 steps known as RICE therapy to help bring down swelling and support the injury:

  1. Rest– try not to put weight on it and stop any exercise or activities
  2. Ice– apply an ice pack (or a bag of frozen vegetables wrapped in a teatowel) to the injury for up to 20 minutes every 2 to 3 hours
  3. Compression– wrap a bandage around the injury to support it
  4. Elevate– as much as possible keep it raised on a pillow

To help prevent swelling, try to avoid heat, such as hot baths and heat packs, alcohol and getting to a physiotherapist early for some soft tissue massages can aid with this.

When you can move the injured area without pain stopping you, try to keep moving it so the joint or muscle doesn’t become stiff.


Phase 2: Regain Full Range of Motion

If you protect your injured ankle ligaments appropriately the torn ligaments will successfully heal and achieve a normal functional length. Mature scar formation takes at least six weeks. During this time period you should be aiming to optimally remould your scar tissue to allow for full functional ankle movement and prevent a poorly formed scar that will re-tear in the future.

It is important to lengthen and orientate your healing scar tissue via massage and exercises designed to address your joint range of motion, muscle length and normal neural tissue motion.

IMPORTANT: Researchers have identifies that the history of a sprained ankle predisposes you to a stiff ankle joint that further predisposes you to an array of injuries including ankle sprains, foot pain, calf and leg injuries plus back pain.  Therefore, anyone who has suffered a sprained ankle should seek professional guidance to assess the amount of ankle joint motion you actually have. Please contact your physiotherapist for specific testing and advice.

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