Ankles sprains are commonly known as twisted or rolled ankles and are one of the most common physio injuries. Despite this, they are some of the most poorly treated injuries and due to this, can result in ongoing issues with your affected ankle over time.
Ankle sprains commonly occur when a force is applied to the ankle, forcing it out of its normal range of movement. This puts undue stress on the bones, ligaments, muscles and tendons around the ankle joint. The most common structure that is injured in ankle sprains are the ligaments, as they are there to limit the ankle movement and provide stability to our ankle joint when we walk, run, jump or do any activity on our feet.
Ligament injuries to the ankle can be to the ligaments on the outside of the ankle, which are known as lateral ankle sprains. They can also happen to the ligaments on the inside of the ankle, which are known are medial ankle sprains. The two most common ankle ligaments injured during a sprain are the anterior talofibular ligament (ATFL) and the calcaneo-fibular ligament (CFL), which are both located on the outside of the ankle. This makes sense why most people sprain their ankle with it rolling inwards.
Initially, when you ‘roll’ or sprain your ankle, you may feel a ‘pop’ or ‘cracking’ sensation and feel immediate intense pain. The pain itself may linger for a number of days and even weeks depending on the severity of the sprain. The damage to the ligaments can also result in swelling and a significant amount of bruising around the ankle too.
The level of damage to the ankle ligaments can be classified through various grades of ankle sprain. A Grade 1 ankle sprain involves small tears, while a Grade 2 sprain involves a significant tear in the ligament. A Grade 3 sprain is a complete rupture of the ligament.
Seeing a physiotherapist in the first 24-48 hours after ankle sprain can help diagnose and treat your ankle sprain, reducing further damage. Additionally physiotherapists will aim to keep you active and moving, doing as much as possible without aggravating or irritating your ankle sprain, ensuring it still heals as soon as possible. To help diagnose your ankle sprain, your physiotherapist might recommend a further x-ray to rule out fracture, as well as an ultrasound or an MRI to determine the level of damage to the ligaments.
The goal of the first stages of rehabilitation is to reduce swelling, pain, as well as restoring pain-free movement in your ankle. This would then be progressed to slowly tolerating loads and putting pressure through your foot and ankle. The third stage would involve strengthening the muscles and tendons around the ankle that provide muscular stability to the joint. This is important, especially as the stability of the ligamentous structures have been compromised with the sprain.
The final stage of rehabilitation would be restoring high functioning tasks. Some types of exercises involved would be proprioceptive and balance exercises, endurance and power exercises (plyometric & jumping). This ensures the ankle is robust and fit to return to sport and high level activities without spraining in the future. If you need help with your ankle rehab, reach out to us today!