ANKLE SPRAINS

What is a sprained ankle?

A sprained ankle occurs when the medial (inside) or lateral (outside) ligaments that support the ankle are overstretched or torn. This usually happens through activities such as running, jumping, sharp direction changes, stepping on uneven ground or falling down.

A ligament is a strong band of connective tissue which attaches from bone to bone. It supports the ankle and prevents excessive movement. Ankle sprains usually occur on the lateral side of the ankle. There are three ligaments that provide stability to the lateral ankle. They are:

• Anterior talo-fibular ligament (ATFL) - goes from the talus to the fibula. This is the most commonly injured ligament.

• Calcaneo-fibular ligament (CFL) - goes from the calcaneus to the fibula

• Posterior talo-fibular ligament (PTFL) - goes from the talus to the fibula

The soft tissues and even the bones around the ankle can also become damaged when you sprain your ankle. Afterwards, muscle weakness and tightness, joint stiffness and poor proprioception can complicate the healing process and predispose you to future ankle sprains. Therefore it is important to seek appropriate treatment from your physiotherapist

What are the signs and symptoms of a sprained ankle?

• audible tear or snap at the time of injury
• pain and swelling
• bruising
• stiffness and reduced range of motion
• inability to put weight through injured leg

What can you do to help?

In the first 48 - 72 hours:

• RICE- Rest, Ice, Compression, Elevation. Use crutches and anti-inflammatory medications if necessary

Avoid activities that aggravate your ankle, ie. Increases pain or swelling 

• During the activity
• Upon rest after activity, or
• Increases the morning after activity

What can a physio do to help?

A physiotherapist will usually be able to diagnose a sprained ankle. Sometimes X-rays, MRIs or CT scans can confirm diagnosis and rule out other injuries such as fractures. Treatment may include:

• soft tissue massage
• joint mobilization
• anti-inflammatory advice and education
• ankle taping or bracing
• exercises to help improve flexibilty, strength and balance
• electrotherapy (eg. ultrasound)
• biomechanical correction
• a gradual return to activity program

Residual ankle instability - Occasionally the ligaments may not heal completely and become weaker or looser than pre-injury levels. This causes the joint to become more unstable, which puts you at a higher risk of re-spraining your ankle. The more frequently you sprain your ankle, the greater chance you have of re-spraining it yet again. Therefore, physiotherapy treatment for sprained ankles is important in order to reduce the chance of further sprains.

EXERCISES FOR SPRAINED ANKLES

Plantarflexion/Dorsiflexion (Foot pumps)

• Point your foot up and down as far as possible without causing pain

Progress: add Theraband for resistance

Inversion/Eversion

• point your foot inwards and outwards as far as possible without causing pain

Progress: add Theraband for resistance

Calf strengthening

• stand in front of a steady table or wall

• do a heel raise onto your toes

• hold for 5 seconds and slowly come down

Progress: do this on the stairs, holding on to the rail. Have half your foot on the step so that you can bring your heel below your toes and stretch your calf

Calf stretches

Lunge stretch

• lunge facing the wall, with your front leg bent and back leg straight

• keep your back heel down, and gently lunge forward until you feel a stretch in the back leg and knee

Knee to wall

• lunge facing the wall with the front leg bent and slightly away from the wall

• keeping your front heel down, lunge forward until the front knee touches the wall. You should feel a stretch in the lower calf of the front leg

Balance

• Heel raises
• Single leg stance
• Single leg stance plus heel raise

Advanced training

• Step ups/downs
• Hopping
• Figure 8s, zig zags
• Running

Perform 10-20 repetitions of each prescribed exercise,and repeat 3 times a day. These exercises should not cause or increase pain. Please contact your physioFIX physiotherapist if you have any questions regarding this information.