ANKLE SPRAINS
Ankle sprains are common injuries that occur when the ligaments surrounding the ankle joint are stretched or torn, typically due to sudden twisting or rolling of the ankle. Ligaments are strong bands of tissue that connect bones and provide stability to joints. Ankle sprains can range from mild (Grade 1) to severe (Grade 3), depending on the extent of ligament damage.
Understanding Ankle Sprains:
Causes: Ankle sprains often occur during activities that involve rapid changes in direction, jumping, or uneven surfaces. Common causes include:
Rolling or twisting the ankle inward (inversion injury).
Landing improperly after a jump.
Tripping or stumbling over an object.
Sports activities such as basketball, soccer, or running.
Symptoms:
Pain, swelling, and bruising around the ankle joint.
Difficulty bearing weight on the affected ankle.
Instability or feeling of "giving way" in the ankle.
Stiffness and limited range of motion in the ankle joint.
Diagnosis: Diagnosis of an ankle sprain is typically based on clinical evaluation, including medical history and physical examination. Imaging studies such as X-rays or MRI may be ordered to rule out fractures or assess the severity of ligament damage.
How Physiotherapy Can Help with Ankle Sprains:
Physiotherapy plays a crucial role in the management of ankle sprains by promoting healing, reducing pain and swelling, restoring range of motion and improving strength and stability of the ankle joint. Here are ways physiotherapy can help:
Initial Management (RICE Protocol):
Rest: Protecting the injured ankle and avoiding activities that exacerbate symptoms.
Ice: Applying ice packs to reduce swelling and inflammation in the first 48-72 hours post-injury.
Compression: Wrapping the ankle with an elastic bandage to support and stabilise the joint.
Elevation: Keeping the injured ankle elevated above heart level to reduce swelling.
Pain and Inflammation Management:
Physiotherapists use modalities such as ultrasound, electrical stimulation or ice therapy to alleviate pain, reduce swelling, and promote healing of damaged tissues.
Range of Motion Exercises:
Gentle ankle range of motion exercises help maintain or restore flexibility and mobility in the ankle joint. This includes toe curls, ankle circles and gentle stretches.
Strength and Proprioception Exercises:
Progressive strengthening exercises focus on the muscles around the ankle (e.g. calf muscles, peroneal muscles) to improve stability and support the injured ligaments. Exercises may include calf raises, ankle dorsiflexion/plantarflexion exercises and resistance band exercises.
Proprioception exercises (balance and coordination training) help retrain the neuromuscular control of the ankle joint, reducing the risk of recurrent sprains. Examples include single-leg balance exercises and balance board drills.
Manual Therapy:
Techniques such as joint mobilisations, soft tissue massage and myofascial release can help reduce muscle tightness, improve tissue mobility and restore normal joint mechanics in the ankle.
Functional Rehabilitation:
Gradual progression to functional activities and sports-specific exercises to safely return to previous levels of activity. This includes agility drills, jumping exercises and sport-specific movements to ensure readiness for return to sport or daily activities.
Education and Prevention:
Physiotherapists provide education on proper ankle care, including injury prevention strategies, proper footwear and techniques to avoid re-injury. They may also recommend ankle braces or supports during activities for added stability.
Benefits of Physiotherapy for Ankle Sprains:
Optimised Healing: Physiotherapy promotes optimal healing of injured ligaments and tissues, reducing recovery time and minimising long-term complications.
Improved Function and Mobility: Restores range of motion, strength and stability to the ankle joint, allowing individuals to return to normal activities with reduced pain and improved function.
Preventive Strategies: Education on proper rehabilitation exercises, techniques to improve proprioception and strategies to minimise the risk of recurrent ankle sprains.
In summary, physiotherapy is essential in the management of ankle sprains, providing comprehensive, personalised treatments aimed at reducing pain, improving mobility, restoring strength and stability and facilitating a safe return to daily activities and sports. Early intervention with physiotherapy can significantly improve outcomes and reduce the likelihood of future ankle injuries.