Rolling and spraining your ankle can be both annoying and frustrating. If you’re like me and have rolled your ankle at some point in your life so far (whether that be changing direction in a game of netball or running and rolling your ankle in a pot-hole or on uneven pavement), you’ll know that the recovery can be slow and challenging.
We get it, ankle sprains are tedious and annoying injuries to sustain, and it’s difficult to know when exactly you can start to return to the activities you like to enjoy day to day.
The ankle complex
The ankle is made up of many joints and ligaments that help provide both stability of our joints, but also allow flexibility so that the foot and ankle can dynamically move which is essential to complete everyday activities like walking or climbing stairs. The most common type of ankle injury is an inversion sprain, this is where the lateral ligaments (on the outside of your ankle) such as the ATFL, CFL and PTFL are most commonly injured (see below). This can result in pain, swelling and bruising around the ankle.
Treating a sprained ankle well and completely is a fundamental component to preventing long-term ankle issues, and an important process to help our strength and balance systems return to normal.
How do I know if I have sustained a lateral ligament ankle sprain?
· There has been an event where you “rolled” your ankle
· Tenderness over the lateral ankle
· Loss of movement in the ankle
· Inability to put all your weight down on the ground
· Pain and swelling
· Swelling that often gets worse at the end of the day
· Poor standing balance, or feeling unstable with lateral movements
· Pain with walking, running, jumping activities
When do I need an XRAY?!
Not all ankle sprains will need an XRAY. The ‘Ottawa ankle rules’ are used to guide clinicians (such as physiotherapists and doctors) to know when someone may benefit from an xray, as it may be helpful to rule out a suspected fracture.
If you cannot put weight on your foot immediately after injury or walk 4 steps when you first try to weight-bear after injury, and also have some bony tenderness over the outside or inside of your ankle bones then visit your local Emergency Department, GP or acute medical centre.
If you are unsure, please check with your local physiotherapist or GP.
What can I do in the early phase of healing?
Here are some clear and simple steps you can take to help path the road to recovery so that you can get back to doing the things you enjoy!
After you sprain your ankle, just remember,
PEACE & LOVE! This acronym is the new and improved version of the previously known RICER which you may be familiar with.
PROTECTION – avoid activities and movements that increase pain in the first few days after injury
ELEVATION – Elevate the injured limb higher than the heart as often as possible
AVOID ANTI-INFLAMMATORIES – Avoid taking anti-inflammatory medications as they reduce tissue healing. Avoid icing
COMPRESSION – Use an elastic bandage or taping to reduce swelling
EDUCATION – Your body knows best. Avoid unnecessary passive treatments and medical investigations and let nature play its role.
LOAD – Let pain guide your gradual return to activities, your body will tell you when it’s safe to increase the load.
OPTIMISM – Condition your brain for optimal recovery by being confident and positive
VASCULARISATION – Choose pain free cardiovascular exercises to increase blood flow to repairing tissues
EXERCISE – Restore mobility, strength and proprioception by adopting an active approach to recovery
What shouldn’t you do after your ankle injury?
The general consensus for soft tissue injuries is to do no “HARM”, this involves avoiding:
- Running/excessive weight bearing
When does my rehab start? Do I need to see a Physiotherapist?
Your rehab should start as soon as you injure your ankle, this involves applying those tips above, to help reduce swelling and regain movement. Everyone is different, and to ensure you’re getting back to those activities that you want to be doing as soon as possible, see a physiotherapist to help tailor your rehab to your own goals and abilities.