What is an ankle sprain?
An ankle sprain occurs when the ankle is rolled and the ligaments on either side are stretched beyond their capacity, eventually causing them to tear. These tears are graded from grade 1-3, with grade 3 indicating a total rupture of the ligament. There are 3 ligaments on the lateral aspect of the ankle; the ATFL (anterior talofibular ligament), the CFL (calcaneofibular ligament) and posterior talofibular ligament (PTFL) which operate similar to a trap door system, in terms of strength. The ATFL is the most commonly injured ligament in the body. On the medial side of the ankle we have the deltoid ligament, which is a strong triangular shaped ligament which is much less commonly injured.
What are the first steps I should take at home to treat it?
When you believe your injury fits the description of an ankle sprain there are a few things that you need to do once you get home: Follow the RICER protocol:
- REST – Try to rest your foot as much as possible. If you do need to walk, then try to get crutches or a moonboot from your physiotherapist
- ICE – Apply ice as soon as possible. Aim for 12-15 minutes every hour for the first 48-72 hours. Remember not to apply ice directly to your skin – use a towel to cover.
- COMPRESSION – Apply a compression bandage to the area above and below the injured area to help with the swelling. Ensure the bandage is not too tight.
- ELEVATION – Place the injured foot on a pillow and elevate as high as possible on a coffee table or chair.
- REFERRAL – It is recommended that you see you Physiotherapist 3-5 days after your injury as it this time they can best assess your ankle.
How do I know if I have sprained my ankle?
When you sprain your ankle you will usually feel it roll inwards or outwards with a rapid movement. This will always be followed by immediate pain and swelling. Research shows that the amount of pain is a good indicator of the severity of the sprain. You may also notice an egg like structure developing on the outside of your ankle which will be soft to the touch – this may be indicative of a ligament tear. You will also notice restriction with movement and bruising may start to develop in the days following.
What are the causes of an ankle sprain?
- Ligament weakness due to previous injury
- Landing awkwardly from a fall
- Twisting mechanism on an unstable surface
- Poor balance and proprioception
- Poor lower limb strength and co-ordination
- Improper footwear for the conditions
How do I treat an ankle sprain?
- Range of motion exercises
- Strengthening exercises
- Manual therapy from your physio to restore movement
- Dry needling to help pain and reduce muscle spasm
- Education for prevention of future injury
- Bracing and tape for comfort
How do I prevent this from happening in the future?
- Adequate warm up before sports
- Bracing and taping for extra stability
- Ensure balance and proprioception are adequate
- Regular strength training
- Jumping and landing conditioning
- Complete a Star Excursion Balance Test (SEBT) which identifies strength and balance differences between both sides of the body