Injuring your ankle can be a painful and stressful experience, which can occasionally lead to long-term pain and instability. Check out the following blog post to learn how you heal a sprained ankle, and how to prevent the long-term problems that may arise from it!!
What is a sprained ankle?
A sprained ankle occurs when you damage one (or more) of the ligaments around your ankle. While there are multiple ligaments around your ankle, the most common ligament which is injured is called the anterior talofibular ligament (bit of a tongue-twister we know!), or ATFL for short.
The ATFL is located on the outside of your foot, attaching from the outside ball of your ankle (the lateral malleolus) to a bone at the top of your foot (the talus). It’s job is to stabilize the ankle joint, and to stop you from rolling your ankle excessively.
The anterior talofibular ligament (ATFL) is the most commonly injured ligament when you roll your ankle
The ATFL (and to a lesser extent the other ligaments around your ankle) is most commonly injured when you roll your ankle, and can often occur when you are walking or landing on uneven surface (like on rocky ground or uneven terrain). It is a common injury for athletes to sustain while partaking in sport. In severe ankle sprains, it is possible to fracture your ankle at the same time as you sprain it.
When you sprain your ankle, varying amounts of ligament fibres are torn. This is classified into 3 grades of tear:
- Grade 1 – a small tear, with little swelling or tenderness. You can normally walk OK afterwards
- Grade 2 – a large tear, leading to pronounced swelling and bruising, pain when you walk, and instability of the ankle.
- Grade 3 – a complete tear of the ATFL (normally), and possible injury to other ankle ligaments. A large amount of swelling and bruising is present, and walking/ weight bearing on that side is impaired.
What is the treatment of a sprained ankle?
Firstly, it is important to note that as it is possible to fracture your ankle when you roll it, if you have had a significant injury you may need to visit the emergency department or review with your family doctor initially. While this may not be necessary a lot of the time, do bear it in mind if you can’t put weight on your foot or if you have excessive swelling and bruising.
After your injury, the first 24 hours are essential to help to reduce damage around the ankle and help the soft tissues in the area heal. Following the RICE protocol is essential, and are as follows:
- REST – this will help prevent further bleeding and swelling inside the ankle joint.
- ICE – icing also helps to reduce bleeding and swelling inside the ankle joint, and can be applied as crushed ice wrapped in a moist cloth, a frozen gel pack or an instant ice pack. It is important to have a towel or cloth between the ice and the skin, and a rule of thumb is apply for around 10 minutes at a time.
- COMPRESSION – compressing the area with a firm bandage both during and after ice application also helps to reduce bleeding and swelling. It should not be applied too tightly so as to cause pain.
- ELEVATION – elevation of the affected foot will help swelling to move away from your foot. The elevated foot should be raised higher than your pelvis, and can be propped up on pillows or a chair.
After the initial 48 hours from your accident, starting physiotherapy is a vital part of the recovery of your ankle sprain. Your physiotherapist will be able to assess your injury to help to diagnose exactly which ligament(s) you have injured and the extent of your injury, and may use hands on techniques and/ or treatment modalities (such as ultrasound) to help your ankle to heal.
As you progress through your therapy, it is essential that you are prescribed a thorough exercise plan by your physiotherapist. It is very common following this kind of injury that you may lose motion around your foot and ankle, and that the muscles around your ankle become weak and deconditioned. When you lose movement and strength in your foot, it can cause further pain, swelling and instability around the ankle. It is also normal for you to lose your balance during this process. All of these things can lead to you rolling your ankle again in the future, which can become a vicious cycle. It is imperative that you regain this range of motion and strength to fully recover from your ankle sprain.
It is also important to note that while your ankle may appear to be healed after 4-8 weeks following your injury, the lack of balance and strength can last for months and years afterwards if not addressed adequately. As mentioned, this is what can lead to further ankle sprains down the line.
What should I do next?
With all this in mind, by the time you are reading this you or someone you know have probably already injured your ankle and are looking for more information about what to do. If you want to maximize your recovery following injury, arranging an appointment with one of our physiotherapists is a great way to get some help and learn the next steps in your recovery. If you want to learn more about our physiotherapists, check out our staff page, or if you are ready to work with a physiotherapist you can book online or call our clinic at 250-493-1152.