The ankle is the most commonly injured joint in the body!
How do ankles sprain?
A sprain occurs when the ankle is twisted in a sideways motion resulting in injury to the ligaments and soft tissues that restrain the joint. 90% of ankle sprains occur when the foot is rolled inwards stretching and damaging the ligaments on the outside of the ankle.
Landing and jumping sports like netball and basketball have a high incidence of ankle sprain. High heel shoes also increase the risk of sprain. It’s just too easy to roll off the edge of the pavement or on uneven ground!
The degree of symptoms tend to correlate with the degree of injury. Ankle sprains are classified into 3 grades.
Grade 1 sprains involve a mild stretch of the ligament which usually resolves within 2-7 days. These usually resolve without treatment, but make sure you don’t lose any important dorsiflexion (upward bend of the ankle) movement!
To check: keep your heels on the ground, bend your knees over the mid foot making sure your knees don’t roll inwards. Both knees should move forwards the same amount. If restricted, come in for a quick check.
Grade 2 sprains are moderate injuries involving a partial tear of the ligament. The ankle is moderately swollen and very painful.
Grade 3 sprains are severe and involve a complete rupture of the ligament. They are significantly swollen but may not be that painful. The ankle will often feel unstable.
First aid measures
Rest, Ice, Compression and Elevation is still the treatment of choice in the early stages of any acute ankle sprain. RICE controls the swelling, eases the pain and prevents further tissue damage.
Avoid heat and alcohol. No wine or beer in the spa!
Should I seek treatment?
If the ankle swells considerably and it is difficult to walk you should definitely seek help from a Physiotherapist.
A physiotherapist with assess the grade of injury and ascertain if there is any structural damage. An important part of this examination is testing the stability of the ligaments.
Management of a Grade 3 ankle sprain is critical. The damaged ligament must be immobilized to some extent (ankle stability brace) to allow the healing process to repair the ligament.
Poorly managed Grade 3 sprains often result in a lifetime of instability.
Rehabilitation of Grade 2 and 3 ankle sprains involves restoration of normal range of motion, muscle strength and balance reactions (proprioception).
A reduction of range of motion may lead to compensatory motions elsewhere. A common result of this is knee pain further down the track. Lack of strength or balance response will increase the likelihood of other injuries later. A small number of treatments and a bit of effort with rehab on your behalf can avoid a multitude of future problems!