Ankle sprains resulting from trauma or previous injury present in many different ways.
The treatment regime for ankle sprains differs considerably between patients. This is because the ankle joint has many complex structures and functions.
The best way to rehabilitate and resolve ankle injuries is to get a proper diagnosis by a professional in the field.
Ankle sprains are the most common cause of ankle injury and pain, totalling 10-30% of all sports related musculo-skeletal injuries. However, are not limited to sports. Simple day to day activities, such as walking on uneven footpaths or stepping down a gutter, can cause you to lose your balance. If you place your foot in the wrong position a painful stretch or tear to the ankle ligaments can occur. This is likely if you have a history of an ankle sprains which were not correctly rehabilitated, leading to chronic ankle instability.
Majority of ankle sprains result from rolling out (inversion) injuries, where the ligaments on the outside of the ankle are injured. Rolling in (eversion) injuries are rare and require considerably more force to damage the ligaments on the inside of the ankle.
Ankle sprains are graded from 1-3 depending on severity.
Grade 1 Ankle Sprains:
Minor in nature, minimal swelling, minor pain and stiffness. Able to weight bear with little or no joint instability. No loss of tension in ligaments and back to normal activities within 1-2 weeks.
Grade 2 Ankle Sprains:
A significant injury, often unable to weight bear, with more diffused swelling and pain. Loss of ligament tension is displayed, with a 2-4 weeks period before being back to normal activities.
Grade 3 Ankle Sprains: A gross injury and disruption of ankle stability. Severe swelling and bruising, extensive ligament damage and multiple injuries. Will take up to 6-8 weeks to be back to normal activities. Return to normal activities is assuming that correct rehabilitation and treatment is undertaken.
Diagnosing Ankle Sprains:
- Clinical examination, assessment and grading.
- Diagnostic ultrasound to determine the extent of damage.
Treatment for Ankle Sprains can be Divided into Two Sections:
- Acute immediate treatment.
- Rehabilitation and prevention of re-occurrence.
Immediate Treatment for Ankle Sprains Includes:
- Rest, Ice, Compress, Elevate (to decrease initial inflammation, bleeding and swelling).
- Anti-inflammatory medication for pain if required.
- Low-dye strapping.
- Partial weight bearing (i.e. crutches) as soon as pain will allow to aid in rehabilitation.
- Moon boot or non-weight bearing cast, if injury is significant.
Rehabilitation for Ankle Sprains:
Prolotherapy, dry needling and foot mobilisation therapy
Strapping and supportive footwear.
Range of motion exercises.
Gentle calf stretching.
Ankle strengthening and rehabilitation proprioception training (i.e. wobble boards, balance exercises).
Customised foot orthoses.
Unfortunately, some people with a history of repetitive ankle trauma do not progress well. They complain of persistent pain and ankle instability (depending on the grade of the initial injury).
This is a result of inadequate rehabilitation or sufficient treatment. A review or repeat of diagnostic test (X-ray, US) may need to be undertaken. MRI, bone scan or CT scan can be indicated if there are any other conditions or injuries impacting on the ankle.
The Podiatry Clinic is experienced in dealing with acute and chronic ankle sprains and strains. We will provide you with an extensive rehabilitation program to strengthen your ankle and help you back to normal weight bearing activities and sport.