An ankle sprain is a frequent injury to the musculoskeletal system, characterised by the stretching or tearing (either partially or completely) of the ankle ligaments. These injuries typically happen when the ankle is forced beyond its usual range of motion, often observed in active individuals and athletes.
The ankle joint ranks second among joints most susceptible to sports injuries, with ankle sprains being the most prevalent injury affecting this joint.
The most common ankle injuries are lateral ligament sprains and females have the highest rate of injury. The dominant leg is over two times more susceptible to sprains compared to the non-dominant leg.
Mechanism of injury:
Lateral ankle sprains typically occur when there is a sudden shift in the body’s centre of mass over the foot that bears weight or lands. This movement causes the ankle to roll outward and the foot to turn inward, resulting in stretching and tearing of the lateral ligament. Once a ligament tears or stretches beyond its normal elasticity, it rarely returns to its original strength and resilience. Research indicates that premature return to physical activity can compromise the proper healing of the ligaments.
How physio can help:
Physiotherapy plays a crucial role in the management of ankle sprains, particularly among athletes, where treatment strategies differ based on the severity and duration of the injury phases.
For acute mild sprains lasting four weeks or less, the primary goals of physiotherapy are to reduce pain and swelling while protecting the joint and ligaments from further damage. Typically, recovery for such cases ranges from 5 to 14 days. In contrast, chronic and more severe sprains, lasting over four weeks, require physiotherapy to focus on alleviating pain and edema, and restoring functional movement and stability, with recovery periods spanning 3 to 12 weeks or longer.
The standard treatment protocol involves PRICE (Protect, Rest, Ice, Compress, Elevate). Initially, the injured ankle is rested for 72 hours, with possible use of crutches for protection in severe cases. Ice application helps reduce swelling and pain, while compression using a bandage or brace stabilises the joint. Elevating the ankle aids in pain and edema management.
Although some approaches suggest minimal intervention for first-time lateral ligament sprains, high recurrence rates (70%) underscore the need for comprehensive rehabilitation despite guidelines that may not routinely recommend physiotherapy referrals.
The initial stages of physiotherapy focusses on pain management by providing education, performing manual therapy and prescribing gentle exercises. As the ankle heals it is vital that strength, balance and coordination exercises are prescribed to prevent chronic ankle instability. This comprehensive approach to physiotherapy ensures optimal recovery and functional restoration following ankle sprains.
Strapping:
Ankle bracing and taping are commonly used as preventive measures, supported by increasing research. Taping can stabilise the joint by limiting motion and enhancing proprioception.