Understanding Ankle Sprains: Your path to treatment and recovery

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Think ankle sprains are simple? Think again. While ankle injuries are one of the most common injuries that occur on the field or court by people of all levels, it doesn’t mean they should be ignored when it comes to seeking treatment. 

Ankles are more complicated than they may seem. We could go on about how the  foot and ankle is comprised of 33 bones, with 26 joints being supported by numerous important ligaments… but what you need to know is this: 

Without treatment and/or a structured rehab plan for your ankle sprain you could experience further issues down the track, such as recurrent sprains or even chronic ankle instability.

Typically, ankle sprains occur when the foot is rolled underneath our bodyweight due to abrupt changes of direction, stepping on uneven terrain, landing after jumping, or various other sporting movements.

The most common type of ankle sprain is an inversion sprain, where the bottom/sole of the foot is rotated inward, placing strain/stretching force into the lateral ligaments. In more simple terms – the outside of the ankle. However, they can happen the other way too –  eversion sprains cause injury to the deltoid ligament that supports the inside of the ankle.

So, what then is the process of treating such an injury?

Assessment and treatment for your ankle injury

Ankle sprains are graded from mild to severe depending on the degree of ligament disruption. The rehab and overall management will depend on the degree of the sprain and the type of activity the individual hopes to return to. Let’s talk through the steps:

1. Thorough Assessment:

Your osteopath will use a variety of strategies to determine the location and severity of your injury, including weight-bearing active movements, range of motion assessment, and special tests. The assessment will help determine the best initial steps of rehab, and whether additional screening may be needed such as XRAY or MRI to rule out additional diagnoses.

2. Initial Care and Pain reduction:

Once the diagnosis of ankle sprain is confirmed the first stage of management will likely include a period ranging from a few days to a few weeks where the injured ankle is protected from additional irritation. This stage may include strategies to help unload the injured ankle such as avoiding excessive weightbearing, using ice, compression, elevation to help manage swelling and pain in the short term. In more severe cases, your osteopath may recommend using some additional support such as bracing or rigid taping if suitable. Range of motion exercises can be explored in this initial phase with the goal of minimizing deficits and improving pain free mobility.

3. Early Weightbearing and optimal loading:

Current evidence supports the importance of establishing an early return to weightbearing once the acute symptoms have been managed. This early return to weightbearing is believed to help reduce potential motor pattern changes that can occur due to longer periods of immobilisation. Exercises in the phase will often include controlled movements that can be performed with minimal pain that load the ankle, strengthen surrounding musculature and further improve range of motion. Examples may include single leg strength, balance and proprioception exercises, calf raises, squats etc. This stage is different for each individual and will reflect their healing capacity, and the extent of tissue disruption in the ankle joint.

 4. Coordination and graded exposure to load:

As the injury progresses and the ankle tissues are tolerating a variety of weightbearing strength and mobility exercises, your osteopath may begin to introduce specific exercises that train movement patterns or skills needed to return to your specific sport or hobby. Exercises may be progressed by adding weights, or perhaps involving plyometric movements that require the tissue to express elasticity and tolerance to higher levels of force.  As the rehab begins to look more like your normal sport/training we are helping to stimulate tissue healing and promote the overall capacity for your ankle to handle movements required in your specific sport.

 5. Return to sport:

The final phase of rehab will be reproducing exercises that are very specific to the sport that you are hoping to return to. For example, if you are a soccer player, you will need to have the capacity to tolerate running, lateral movement, kicking and jumping. Therefore, your training will need to include exercises that mimic those movements in the form of plyometrics, running etc . The importance of exposing the ankle to these sport specific movement in small dosages at the beginning, and gradually increasing the load and demand over time is what will allow for a smooth transition back to sport and hopefully reduce ongoing issues in the ankle.

 Some key points to remember during your ankle injury rehab:
  1. Listen to your body in the initial days/weeks to allow pain and swelling to diminish before jumping straight back into your usual sport. Doing too much too soon can delay the healing and continue to stir up the irritated tissues. While complete rest is not always needed or recommended, reducing the total load on that ankle to protect it in the short term will allow you to get into the next stages of rehab.
  2. Quality over quantity: As with most injuries, successful rehab is a plan that applies the correct amount of stress to the tissues in order to promote a healthy tissue response without overdoing it to the point the stress surpasses the tissues recovery capacity. A clear strategy and plan will help provide a framework with specific steps and goals that can help make sure your recovery stays on track.

By following these steps and working closely with your osteopath, you can effectively manage and recover from an ankle sprain, reducing the risk of future issues and injury. Let us help you get back to doing what you love sooner! 

 

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