An ankle sprain is the inflammatory process caused by trauma to the ankle joint. Signs of an acute ankle sprain include general swelling / oedema, constant or intermittent pain with weight-bearing or active movement and bruising or though there are some instances that bruising does not occur.|
Upon injury to the ankle you should quickly ascertain the severity of the injury. Note any swelling, structural deformities (i.e. possible fracture) and level of pain with active-free movement (i.e. movement with no resistance) of the ankle. If the level of the persons’ pain is mild or moderate then proceed to apply the following procedure:
R – Rest or discontinue from further physical activity
I – Ice treatment / apply damp ice pack to the injured area
C – Compression / wrap a compressive bandage about the joint
E – Elevation / raise the ankle preferably above the level of their heart if lying or in ˝ sitting
R – Referral to a health professional (i.e. doctor, physiotherapist) who would monitor their progress and implement the appropriate rehabilitation program.
If the injured person is unable to move independently they should be assisted or carried to a safe and comfortable area. If a fracture is suspected then the lower limb should be immobilised by either binding both feet together or splinting the ankle. Your physician will admit you immediately to an accident and medical clinic or the A&E department at the nearest hospital.
Following a referral from a doctor it is recommended that physiotherapy will assist with full recovery.
Firstly , they will re-assess the ankle giving a concise diagnosis as the term – ankle sprain is general where there may be ligament, muscular or tendon damage, a joint / mechanical dysfunction or possibly conclude an avulsive fracture (i.e. base of the 5th Metatarsal). Grading the severity of the injury (i.e. ligamentous damage) is relative to the level of disability:
Grade I – Over-stretching of the ligament but still intact
Grade II – Partial tear of the ligament with moderate swelling and inability to fully if not partial weight-bear / stand.
Grade III – Complete tear / unstable joint
The above grades of injury all have corresponding treatment regimes that will implemented upon a concise diagnosis
Treatment (i.e. Grade I Lateral ankle sprain)
Includes specific instructions for acute care management:
Issued a tubigrip / crepe bandage for compression and worn all the time except when sleeping
Medication prescribed by the doctor – NSAID / Analgesics
Elevation when inactive
Application of an ice pack 20 minutes – 2 hourly
The above is recommended for the first 3-5 days post injury, then stage II is implemented as symptoms subside. The next step is to rehabilitate the joint so it is strong and stable when they perform ADL (i.e. Activities of Daily Living) or return back to sport.
Exercises may include wobbleboard / mini-tramp – proprioceptive retraining, resisted theraband strengthening, dynamic weight-bearing drills, passive lengthening stretches of achilles–gastrocnemius–peroneal muscle groups, soft tissue massage, deep transverse frictions, joint mobilisation, electro-therapy and rigid strapping for the joint for stabilising and proprioceptive input.
Following this regime should see the injured person back to optimal health within 1 – 2 weeks approximately.