How to recover when you've sprained you ankle
How physiotherapy can help when you have injured you ankle
You’ve rolled your ankle…..you are struggling to walk around let alone go for a run or play football, or any other sport for that matter. Your ankle hurts!! Knowing what to do next can make the difference between a timely return to activity or a series of ongoing issues.
In this blog article I will give you an outline of the rehab process you can expect at Rehab in Motion and how it is drawn from clinical experience and up to date evidence.
Lateral ankle sprains are really common and are often described as going over on it, whether it is through landing on uneven ground or over a kerb, or being tackled playing sport and your ankle forced over.
Most importantly after an ankle sprain will be to ensure you have not fractured or broken a bone in the ankle. This can be screen for using a series of tests called the Ottowa ankle rules. If any of these are positive or you are unable to take a few steps using that ankle an xray can help to exclude a fracture and is important before starting physiotherapy.
Even if you don't have a fracture it can still be really painful. The next stage is to control the pain, reduce swelling and protect the ankle.
Updated guidelines in 2020 suggest following a ‘PEACE and LOVE’ approach. This will allow the ankle to settle and then introduce some gentle activity and rehab when you feel able to tolerate it.
In the early phases the most important things will be to start restoring range of movement in the ankle, some low level strength, balance and ability to walk well. It can also be important to look at other ways to maintain strength and fitness. Cross training can be a valuable tool if running is off the table, think of rowing, swimming, bike erg or cross trainer.
Restricted range of movement can be common following a sprain. Helping restore this movement is more than simply stretching into it. It could be limited by muscle tightness or joint stiffness. Getting it properly assessed early on will allow you to have the best treatment to restore your function, whether this be stretching, soft tissue work or joint mobilisations.
Combining this with the appropriate strength and loading exercises comes next. Balance is also an important consideration along with the rest of the PEACE and LOVE approach. Testing progress will highlight areas for continued focus of treatment. Once range of motion is restored regaining strength is essential to improve control around the ankle through all the positions it will need to achieve day to day and in your sport. Testing calf capacity, both strength and endurance is an important milestone, along with the peroneal tendons (these support the outside of the ankle) and the tibialis posterior (this supports the inside of the ankle). You will want to see as little a difference as possible when compared to the uninjured side, not only in terms of strength, but also endurance and ability to maintain a tempo of movement through full range.
Next will be building the spring back into hopping and jumping. A guided introduction to plyometrics - landing, jumping and hopping - will help regain these qualities and build confidence to load the ankle and move well. This will lead into change of direction if needed in your sport along with building running tolerance again. Completion of a series of outcomes measures; hop for distance, balance, endurance hopping will all give a measure of performance in the ankle, and add to confidence in the ankle’s ability to perform as needed.
With regular followup and guidance you will be able to progress back to your sport and activity. For some people this can take a few weeks but for others several months is not unusual. If you are struggling to make progress at any stage, further investigation (xray or MRI) can be appropriate along with onward referral to a foot and ankle consultant.
If you have suffered an ankle injury get in touch today to get your rehab started.
Not sure how we can help - use the contact form and we can set up a free phone call to discuss your issue and how we are perfectly placed to get your rehab going.
