- Emma B
Rehabilitation Tips For Recovery From An Ankle Sprain
An ankle sprain is a very common injury, particularly among athletes. The most common type of ankle sprain occurs when the foot rolls inwards and the ligaments on the outer side of the ankle are stretched or torn.
Most ankle sprains will heal with time and simple at-home treatment methods. However, severe ankle sprains may require professional help and rehabilitation. This article provides an overview of the different grades of ankle sprains as well as tips for rehabilitation.
Types of sprain
There are three grades of ankle sprain, each with its own set of symptoms and treatment options.
There are special tests that can be performed by a healthcare professional to determine which ligament has been injured, thus affecting how rehabilitation may differ.
Grade 1: This is a mild sprain that affects only a few ligaments. There is usually only minor pain and swelling. Rest, ice, and over-the-counter pain medication can usually help to relieve the symptoms.
Grade 2: This is a more severe sprain that affects more ligaments. There is usually more pain and swelling. Rest, ice, and over-the-counter pain medication can help, but you may also need to use crutches or wear a boot.
Grade 3: This is the most severe type of sprain, and it can involve a complete tear of one or more ligaments. There is usually a lot of pain and swelling. You will likely need to wear a boot and use crutches.
To discover if you have had a ligament tear, the usual route is to visit A&E which may involve a long waiting process. However, you can book an MRI with MSKdoctors in the same week of ringing and receive a diagnosis almost immediately.
The following is a general guide (POLICE) for the acute care of an ankle sprain. This includes the initial period of injury up to 2 weeks. Typically, the best method for rehabilitation is to achieve goals rather then use timeframes, as most rehabilitation can differ for people.
- Protection: avoid further damage by using crutches while still trying to engage in daily tasks. This can also mean completing the appropriate amount of rest to heal the injury.
- Optimal Loading: this will stimulate the healing processes. Using crutches or help, start to put weight through the injured ankle, but not too much to re-injure. The right amount of activity will reduce swelling.
- Ice: applying ice to the injured ankle can help reduce swelling and pain. Ice should be applied for 15-20 minutes at a time, several times a day.
- Compression: wrapping the ankle with an elastic bandage can help reduce swelling.
- Elevation: keeping the injured ankle elevated above the level of the heart can also help reduce swelling.
Next, is the subacute phase which is once swelling, and pain levels have reduced where more movement can occur. It usually lasts for 4-6 weeks and involves a variety of different therapies and exercises.
These include trying to increase the joint range of motion and focusing on muscle conditioning. For example, isometric exercises (contraction of the muscle, no movement) which may be performed and submaximal isometric exercises to maintain neuromuscular function at a low enough intensity where the collagen fibres are not disrupted.
Isotonic exercises (movement that requires the muscles to resist weight), this could include weight bearing exercises, resistance bands or weight-stack machines.
There also may be exercises to help neuromuscular control involved. These are exercises performed on unstable surfaces like wobble boards or trampolines. You can follow some examples given through the figure below.
Halabchi, F. and Hassabi, M. (2020) “Acute ankle sprain in athletes: Clinical Aspects and Algorithmic Approach,” World Journal of Orthopedics, 11(12), pp. 534–558. Available at: https://doi.org/10.5312/wjo.v11.i12.534.
There are different phases of rehabilitation following an ankle sprain. The initial phase focuses on reducing pain and swelling and restoring the range of motion. The second phase focuses on strengthening the muscles and ligaments around the ankle. And the third and final phase focuses on Return to Sport, which is when patients gradually start to resume activities to eventually return to their pre-injury level of activity. The patient should be able to put full weight through the injured side at this point.
Late-stage rehabilitation for an ankle sprain usually includes a combination of exercises to improve balance, proprioception, and coordination. The goal of this phase is to help patients regain confidence in their ankle and prepare them for a safe return to their previous level of activity.