Posted July 9, 2017
Ankle injuries can range from a mild ligament strain to ligament rupture and fractured bone. A ‘sprain’ is the most common type of ankle injury, caused by twisting or ‘inversion’ rolling of the ankle whilst running, jumping or walking on uneven ground.
Symptoms of ankle sprains vary in severity but usually include pain, swelling, bruising, difficulty walking & putting weight on the foot. The pain, which is usually on the outside (lateral) part of the ankle, is caused by inflammation from overstretching of the ligaments that hold the ankle joint together. More severe grades of strain can partially or completely tear the ligament. The most common ligament affected is the ‘anterior talo-fibular ligament’.
Whilst simple mild strains resolve within 2 weeks with simple measures at home, more severe cases should be assessed by a GP or physiotherapist to ensure there are no complications like rupture of ligament, fracture or high sprain which require specialist management. In this case imaging may be necessary.
The prognosis of a sprain depends on the severity; however pain, swelling and instability of the joint can persist for many weeks in more critical sprains, necessitating a more comprehensive rehabilitation regime through a physiotherapist. The aim of such a recovery regime aims to slowly improve strength and flexibility has several phases:
- Inflammatory Control. RICE should be employed for at least the first week, which means Rest from exertional activities, Ice (20 mins every 2-4 hours), Compression (bandage or taping) & E There may be a need for immobilization by using a boot or crutches. Anti-inflammatory medications should also be used.
- Range of Motion Exercises. Scar tissue in the ligament affects the movements of the ankle joint so exercises should be tailored to slowly improving this range. Towel stretches improve flexibility, toe walking and step ups improve strength and ankle circling can improve mobility.
- Balance Exercises. An injured ankle needs to re-learn joint position sense, or ‘proprioception’ to avoid re-injury and to boost strength. Wobble board exercises are employed or simple measures such as drawing the alphabet with the foot can help this as well as boost mobility.
- Return to activity. A slow re-introduction to previous activities would be tailored to a person, such as a return to sport & exercise.
This article is only intended as a guide and should not replace medical attention. Please book an appointment with your GP if you are worried about any medical condition.