Ankle sprains….Diagnosis and treatment

What is an ankle sprain?

An ankle sprain occurs when you over stretch the ligaments within your ankle. The severity of the soft tissue tears within the ligaments vary from mild, to severe, or even an avulsion fracture. Most commonly this occurs on the lateral (outside) aspect of your ankle mostly during a wide variety of activities especially where jumping, twisting or sudden changes of direction occur.

Grading of sprains for soft tissue damage ranges from 1-3:

Grade 1 – Mild. Up to 5% of soft tissue is damaged with minimal overstretching and mild swelling and tenderness. This should heal with 2-3 weeks of rest
Grade 2 – Moderate. Connective soft tissue remains partially intact with moderate swelling, pain and pain on loading. This usually takes up to 6 weeks to heal
Grade 3 – Severe. Complete tear of connective tissue with lots of pain and inability to use the ankle. Surgery may be required followed by rehab for up to 3 months, especially if returning to sports.

Following an ankle sprain, the ankle becomes weaker and less stable. Once you have sprained it once you are 40-70% times more likely to re-injure your ankle due the instability. As a result with more injuries the ankle sustains, it becomes more and more unstable with longer recovery time.

How is it diagnosed?

Given the location and the mechanism of the injury, this common injury is reasonably easy to diagnose through a physiotherapy examination. The location of the pain may also be swollen and bruised with difficulty moving and weight bearing on that leg. Through a physiotherapy clinical assessment the grade of the sprain with the severity can be assessed for treatment.

When injuring ligaments within the ankle, it is also important to consider other structures local to the area such as tendons and bones. With an ankle sprain these structures could also be sprained/ torn or have fractures which may require treatment and rehabilitation. In severe cases scans may be required to determine all structures involved but is not necessary to diagnose the severity of the sprain.

Treatment options:
In the first 24-72 hours post injury you should ICE your ankle:
R – Rest
I – Ice – wrapped in a towel should be applied for 20 minutes every 2-3 hours
C – Compression – help reduce swelling and inflammation
E – Elevate – help reduce swelling and inflammation

After this time you can commence rehabilitation to regain movement and power within your ankle with out pain and improved balance and proprioception. Within physiotherapy we also aim to reduce inflammation and pain with normal function restored. If you are looking to return to sport or exercise, treatment with a physiotherapist can be modified and gradually graded to ensure stability and confidence in returning to your activity. All exercises are gradually progressed and adapted to suit each individual and their goals.

With physiotherapy rehabilitation the chances of causing a further sprain in the future is significantly reduced, ensuring continued participation in exercise and activity.

Don’t let an ankle sprain stop you from your activity! Come see one of the physiotherapists at Embrace Life for an assessment and treatment to get you back into your exercise!