The ligaments of the ankle joint provide stability by limiting the amount of side to side movement. Ankle sprains occur when one or more of the ligaments become overstretched or torn.
This usually involves a sudden loss of balance, resulting in a twist of the ankle, usually inwards (inversion), damaging the lateral ligaments on the outside of the foot.
Injury severity is usually graded as mild (grade 1), moderate (grade 2) or severe (grade 3), depending on the amount of damage to the ligaments, swelling and stiffness, weight bearing pain and loss of balance.
Sometimes in more severe sprains there is also damage in the inside of the ankle, further above the ankle bone, or bony bruising within the ankle joint. These extend recovery timeframes.
Immediate treatment as for any soft tissue injury for the first 3 days to minimise swelling, bruising, inflammation and pain:
RICER - Rest, Ice, Compress, Elevate & Referral to physio
As well as no HARM - no Heat, Alcohol, Running or Massage
Using ankle taping or an ankle brace is also helpful. Crutches are sometimes necessary for the first few days.
Your GP or physiotherapist will assess if an XRay is required, and encourage RICER to reduce swelling and promote healing.
Sometimes anti-inflammatories are warranted for the first few days, and crutches if walking is uncomfortable.
With good rehabilitation, most ankle sprains heal within 2-6 weeks, with some severe sprains taking up to 12 weeks. Your physio can give you clear timeframes depending on your specific degree of injury.
Rehabilitation includes “hands on” physio techniques to restore full ankle range of movement, as well as exercises.
Physio rehabilitation usually includes:
> Ankle range of motion exercises and stretches to regain full movement
> Calf and peroneal strength to regain strength and balance
> Balance and agility exercises (eg. jumping, hopping)
> Sport drills
> Taping or bracing in the short term to aid early return to sport