Oh no, a sprained ankle!

It’s one of the most frustrating times is when you just can’t “walk it off”.

Let’s take a look at what’s going on down there…

There are three ligaments connecting the top and bottom of the ankle joint on the lateral (outer) side of the ankle. These ligaments are strong fibrous tissues that connect the ankle bones together and play an important role in stabilizing the joint.

A lateral ankle sprain occurs when one of these three ligaments becomes stretched or torn. Lateral ankle sprains are the most common injury of the lower leg and are usually caused by a sudden inward twist, turn, or roll of the ankle. This type of sprain is particularly common in sports involving quick changes of direction and jumping such as soccer, tennis, football, trail running, basketball, and gymnastics. A lateral ankle sprain could also occur from landing on an uneven surface or the edge of a crash pad while bouldering or simply just by walking or stepping on an uneven surface.

 “So… as the old saying goes… Look before you leap!”

 How “bad” is a bad ankle sprain?

           Common symptoms of an ankle sprain include acute pain at the outer side of the ankle at the time of injury, swelling, bruising, tenderness, instability, stiffness, and pain while walking. The symptoms associated with this injury depend on the extent of the damage to the affected ligaments. This ankle injury is graded on a 1-3 scale based on severity.

• A Grade 1 ankle sprain (mild) is characterized by stretching of the lateral ankle with minimal swelling and discolouration. Weight bearing is uncomfortable but tolerable, and the front and outer sides of the ankle will feel tender.

• A Grade 2 ankle sprain (moderate) is characterized by slight tearing of the lateral ankle ligaments. The ligament that is most commonly torn is called the anterior talofibular ligament (ATFL). When a grade 2 ankle sprain occurs, it is common for people to hear or feel a pop at the time of injury. Walking on the injured foot is painful and somewhat difficult. An x-ray should be ordered from a doctor to rule out an ankle fracture.

• A Grade 3 ankle sprain (severe) involves significant connective tissue damage to all the ligaments on the outside of the ankle causing significant swelling and bruising to the lateral aspect of the joint. This type of sprain makes weight bearing extremely difficult. An x-ray should be ordered from a doctor to rule out an ankle fracture.

How to treat an ankle sprain:

           Almost all ankle sprains can be treated without surgery. Ankle sprain recovery time depends on severity and adherence to rehab protocols. Even severe grade 3 ligament tears can be effectively treated through a combination of rest, ice, and physiotherapy. The recovery protocol after an ankle sprain generally follows the following three phases.

• Phase 1 (Unloading): Rest from sport, ice, and compression to reduce pain and swelling in the acute phase of the injury.

• Phase 2 (Partial Loading): Range of motion exercises, stretching, strengthening, and balance exercises. There are a number of gentle exercises for ankle sprain that can be recommended by your physio depending on how mechanism of the injury and stage of recovery. Many of these exercises are included in ankle sprain home treatment.

• Phase 3 (Dynamic and Plyometric Rehabilitation): Complex or sport-specific exercises to allow a gradual return to activities and sports that involve running, jumping, or quick directional changes. Ankle sprain exercises are the final step in returning to your pre-injury life, and should not be avoided.

“Did you hear that? Do your exercises!”

Importance of Physiotherapy for Lateral Ankle Sprain Recovery: 

Everyone always asks, “How long does it take to heal an ankle sprain?” The answer, as with many things in life, is “That depends.” Ankle sprain healing time is impacted by rest, inflammation management, and patient compliance to their rehab program. It is crucial that the ankle is properly rehabbed after suffering from an ankle sprain because one acute ankle sprain predisposes individuals to future ankle sprains or chronic ankle instability. The deficits that normally occur after this type of injury include loss of proprioception (awareness of our body’s position in space), loss of balance and coordination, loss of strength, and loss of ankle mobility.

If you have suffered an ankle injury, come give us a visit at Elios Health located on Main Street and King Edward Avenue. Our physiotherapists will provide you with a complete physical assessment to diagnose your injury, identify any limitations or deficits in strength, range of motion, and coordination you may have, and provide you with a comprehensive treatment plan.

Original Post by Rachel Rubin-Sarganis
Photo by Vlad Tchompalov