Ankle sprains accumulate the highest percentage of sports injuries in total! It is classified as an injury or tear of the ligaments of the ankle, with 85% of these injuries being to the lateral/outer ligaments of the ankle.
Ankle sprains can happen in a number of ways. However, the general mechanism is a forced inversion/inner turning of the ankle, so much that the ligaments get pulled and can’t handle the force. This can either happen in a forced position or by rolling your ankle while taking an uneven step for example. The latter is often most common and usually occurs due to certain predisposing factors.
There are many factors that can cause you to undergo an ankle sprain. Some may include:
- Poor Proprioception (Joint awareness) of your ankle joint
- Weak Neuromuscular Control of the Ankle
- Weakness in the Lower Limb Chain; it may be from knee or hip control
- Lack of Ankle Stability
- Previous Ankle Sprain
- Decreased Ankle Range/Mobility
- Core weakness or instability
Types of Ankle Sprains:
Ankle sprain classification is very important, it lets us, as therapists, as well as you get a better picture of the severity of the injury. So, we can acquire a more accurate and effective treatment plan to get you pain free and back to your normal self!
Grade 1: I microscopic injury to the ligament tissue without causing any macroscopic damage or stretching – minor swelling and pain, can still weight bear with minor impact on normal day to day function.
Grade 2: Ligament remains intact with minor to moderate macroscopic tearing – moderate impact on function, minor pain on weight bearing and decreased sensation proprioception and stability. With localized swelling and pain
Grade 3: Complete rupture of the ligamentous tissue around the ankle – major amounts of swelling and pain – unable to weight bear. Loss of function and decreased stability and proprioception.
So, you have an ankle sprain – what now?
Well firstly, it’s important to find out what grade of ankle sprain you have and what to do straight away. As clinicians we are trained to perform a series of tests to put stress on the tissue structures around the ankle joint. That together with a discussion on exactly how it happened, we are able to come to a correct diagnosis and how bad it is so we know how to approach treatment and formulate a treatment plan tailored for you.
Acute Management: Usually no matter what grade, there is still an element of irritation, inflammation or swelling so normal protocol of PRICE applies. Bandaging for compression, Ice, and relative rest and elevation are essential to begin the healing process. It’s also important to keep the ankle moving with basic ankle movements to keep the blood flowing and preventing the ankle becoming stiff
From here on out, its highly dependent on the grade of the sprain. But a slow gradual increase to activity such as walking and going down stairs in introduced as pain starts to decrease. We use techniques such as taping to increase stability within the ankle as it gives it a chance to recover.
Ankle Stability and Proprioception exercises are introduced almost immediately after you’re able to walk on the ankle. This is due to the fact that after your first ankle sprain, you’re 70% more likely to get another one without rehabilitation, this combined with strengthening of the ankle musculature is the first step to getting you back to your activity.
Over the following weeks, we slowly start to introduce activity into your daily rehabilitation routine, starting with weight training and advanced balancing exercises. This gets your ankle used to stress under load and in positions it normally wouldn’t be in. This is especially important to PREVENT another ankle sprain in your daily life or desired sport.
And finally, to return to sport. No matter what your sport or activity is, your rehab plan is specified and catered to YOU. The exercises will be prescribed to suit your demands and what sport you choose to go back to. Exercise could include power work, speed, balance, change in direction and even biomechanical correction to further improve your ability and take your rehab one step further!
Missing any of these crucial stages, will lead to future discomfort, and re-injury. This would mean that the process would need to start all over again, from scratch. Do yourself, and us a favour.. if you’ve got an ankle injury or you know someone who has, come to us… we will get you in tip top condition and pain free in no time.