ARGH!!!! The Dreaded "rolled ankle"

Ankle sprains and early rehab

The most important question is, can Muscle Therapy Australia help me with my acute ankle sprain? The answer is 100% YES! With a combination of dry needling, soft tissue release, massage, cupping, gentle passive mobilisations, and even some taping, we can help you feel more comfortable during your healing and rehabilitation.

What is the most common type of ankle sprain?

No matter how much we prepare and strengthen, sometimes ankle injuries can occur in many different unavoidable situations, traumatic sports injuries, falling off a curb or step, slipping on a wet floor (or a spring onion in Aldi if you’re Emma’s mam).

The most common type of sprain is when the ankle/foot is inverted and plantarflexed at the same time, this position below:

Now let’s have a look at the anatomy. On the outside (lateral aspect) of the ankle we have 3 main ligaments. A ligament is a soft tissue structure that connects one bone to another bone). The main job of a ligament is joint stabilisation, in this case, it is the ankle joint that is being stabilised.

The ATFL or anterior talofibular ligament is the most common ligament injured in an inversion ankle sprain but sometimes all three of the ligaments you can see below can be injured, this all depends on the mechanism of injury. This can be tested when seeing a therapist by testing the ankle movements and by palpating around the soft tissues.

There are different grade ankle sprains as well, depending on how much damage has been done:

Grade 1: microscopic tearing of collagen fibres and stretching of the ligament, usually minimal swelling, bruising or tenderness but can be uncomfortable.

Grade 2: more damage, some more significant tearing of the fibres but not a complete tear, usually swelling and bruising present as well as some feeling of instability.

Grade 3: complete tear of the ligament, significant swelling and bruising almost always present, loss of mobility and stability. However, some people may still be able to weight bear after this type of injury.

As well as ligament damage, the muscles that go up the lateral (outside) part of the lower leg, known as our peroneals, can also become stretched or strained in an ankle sprain injury, this can make the lower leg feel tender and sore and, in some cases, cause some bruising.

What about a fracture?

It is important to rule out any other significant injury. An X-ray is recommended if you have an inability to walk after the injury or tenderness to touch over certain areas of the ankle bone. If you suspect a fracture may be present, going to be assessed by a therapist or getting a referral for an X-ray/scan from your GP can help rule this out. The sooner you can rule out anything more significant the sooner the recovery can begin.

I’ve sprained my ankle what do I do?

Most people, especially active people, usually sprain their ankle and think “OMG, what will I do, I can’t exercise now for weeks”. Don’t panic this is not the case.

Firstly, we want to let the body begin its healing process, this unfortunately includes swelling and with our feet and ankles being the biggest victim to gravity the swelling can sometimes be pretty significant. The acute phase will last around 48-72 hours and in this time, we should first rule out any other significant damage if it is suspected.

Most of you will have heard of RICE – rest, ice, compression, elevation. Not that this is going to make your leg fall off if you do it, but there is more recent research that suggests using an acronym of POLICE instead.

Protect

We want to protect the area from any further damage, this might include temporarily reducing activity levels, spending less time on your feet and in some more painful or higher-grade injuries the use of crutches for the first few days.

Optimal Loading

Loading the injured ankle early will help with recovery and restoring strength, mobility and function. This should be done within pain tolerance, usually, guidelines will suggest that if you would score 4/10 or less on a pain scale and the pain is not made significantly worse by activity then you are safe to continue.

Some examples of optimal loading could be gentle walking, active or passive ankle movements such as pointing the foot, bringing the foot up towards your shin or even writing the alphabet using your foot in the air, these will all help towards regaining full range of motion. For some people if the pain isn’t too much some gentle double leg calf raises can also begin early on. Other examples can be single-leg balance while you brush your teeth.

Ice

There is a little bit of disagreement within the world of science as to whether ice is good or bad in the management of an acute injury. It is good at reducing pain and inflammation which in turn can help you practice more optimal loading with less pain. However, some evidence would suggest it reduces inflammation which may slow down the body’s natural healing process.

Compression

Compression applied with the use of a compression bandage, elastic bandages or taping can all help to reduce the amount of swelling through pressure. This can aid in recovery by reducing the swelling as well as aiding in improving blood flow and circulation to the area. (careful not to make the bandage or taping too tight)

Elevation

This helps with reducing swelling through the use of gravity, keeping your ankle elevated above your heart to aid in drainage to reduce the swelling. 

Main aims of the recovery process:

·      Reducing swelling and inflammation

·      Restoring full range of movement

·      Restoring proprioception: the awareness of your foot and ankle position in space

·      Increasing strength and stability

·      Return to full activities with sport-specific or lifestyle-specific exercises

If you have suffered an ankle sprain, book in with one of our therapists at Muscle Therapy Australia for an assessment, treatment and exercises to get you on your way to recovery.

We use a wide range of treatment techniques such as: dry needling to increase blood flow to the area, soft tissue release to reduce tension in surrounding musculature, and gentle mobilisations to help improve the range of motion in the joint and help reduce pain. We can also give some simple exercises to get you started, which can be re-assessed and progressed in further sessions.

If it’s a new or old ankle injury, get yourself booked into Muscle Therapy Australia so we can help get you back into action.