ANKLE SPRAINS
What is an ankle sprain?
Ankle sprains are very common, especially inversion ankle sprains. This involves the stretching or tearing of the ligaments that connect the ankle bones on the outside of the foot. A sprain most commonly involves a ligament called the ATFL (anterior talofibular ligament). Most ankle sprains happen during sports but can also happen during everyday activities.
Ankle sprains are very common, especially inversion ankle sprains. This involves the stretching or tearing of the ligaments that connect the ankle bones on the outside of the foot. A sprain most commonly involves a ligament called the ATFL (anterior talofibular ligament). Most ankle sprains happen during sports but can also happen during everyday activities.
Common causes
- Inversion sprains usually occur when the foot is forced into a pointed position and then turned inwards. This injury commonly occurs during sports with a lot of stopping/starting and jumping and with walking/ running along uneven terrain.
- Ankle sprains are more common among those with flat feet.
- Previous ankle injuries. If you've had an ankle sprain in the past and you did not complete exercises to gain your strength and stability back, you have a high chance of re-injury.
- Inversion sprains usually occur when the foot is forced into a pointed position and then turned inwards. This injury commonly occurs during sports with a lot of stopping/starting and jumping and with walking/ running along uneven terrain.
- Ankle sprains are more common among those with flat feet.
- Previous ankle injuries. If you've had an ankle sprain in the past and you did not complete exercises to gain your strength and stability back, you have a high chance of re-injury.
Signs and Symptoms
Ankle sprains range in severity from grade 1 to grade 3. Pain levels, swelling, bruising and the ability to weight bear depends on how bad the sprain is.
Ankle sprains range in severity from grade 1 to grade 3. Pain levels, swelling, bruising and the ability to weight bear depends on how bad the sprain is.
- Grade 1 Sprain: A partial tear where a small number of ligament fibres are torn. Involves mild tenderness and swelling and minimal pain with weight bearing.
- Grade 2 Sprain: An incomplete tear where a significant number of ligament fibres are torn with some loss of function and some degree of joint instability. Involves moderate pain and swelling and definite pain with weight bearing.
- Grade 3 Sprain: A complete tear where all lateral ligament fibres are ruptured resulting in major loss of function and significant joint instability. Involves severe swelling and the inability to weight bear.
Treatment: Depending on the grade of your sprain you may progress more quickly or more slowly through the following program. Only go on to the next phase if the exercises you're currently doing are getting easy and are fairly pain free.
Phase 1 (First 1-4 days)
PRICE (Protection, Rest, Ice, Compression, Elevation)
o Protect your ankle via bracing or taping and crutches (if unable to fully weight bear). You can purchase a brace from the drugstore or your local physiotherapy clinic. You can have your foot taped by someone who is trained to do so (i.e. a physiotherapists, athletic trainer or kinesiologist).
o Avoid sports, running and excessive walking.
o Ice and elevate every 2 hours for 20 minutes. A bag of frozen peas thrown in a pillow case works well.
o If swollen gently compress ankle using an ACE wrap bandage (can be purchased at the local drugstores).
o Elevate ankle as much as possible. When sitting watching TV or lying down at night, prop foot up on a couple of pillows.
Phase 2 (4-14 days)
Phase 1 (First 1-4 days)
PRICE (Protection, Rest, Ice, Compression, Elevation)
o Protect your ankle via bracing or taping and crutches (if unable to fully weight bear). You can purchase a brace from the drugstore or your local physiotherapy clinic. You can have your foot taped by someone who is trained to do so (i.e. a physiotherapists, athletic trainer or kinesiologist).
o Avoid sports, running and excessive walking.
o Ice and elevate every 2 hours for 20 minutes. A bag of frozen peas thrown in a pillow case works well.
o If swollen gently compress ankle using an ACE wrap bandage (can be purchased at the local drugstores).
o Elevate ankle as much as possible. When sitting watching TV or lying down at night, prop foot up on a couple of pillows.
Phase 2 (4-14 days)
Phase 3 (Roughly 2-3 Weeks)
Standing with hands on chair for support, raise heels as high as you can then slowly lower. Repeat 15 times. Do 3 sets/day. Then raise balls of feet and toes as high as you can and slowly lower. Repeat 15 times. Do 3 sets/day. ***Once this is easy you can progress to doing them on your affected leg only.
Phase 4 (Advanced exercises! Only do when all previous exercises are easy and pain free)
Use tape to make a square on your floor. Standing on your affected leg, hop in to the square, then out to the front, then back in to the square, then out to the right, then back in to the square, then to the back, etc. Every time you land from jumping take your time and try to "stick the landing". Only jump again when you have full control of your balance.
Criteria for returning to sport
1. Swelling and redness must be resolved.
2. Walking and running must be pain free and no limp should be observed.
3. Ankle flexibility must be equal to the “good” ankle.
4. Strength should be equal to the “good” ankle.
1. Swelling and redness must be resolved.
2. Walking and running must be pain free and no limp should be observed.
3. Ankle flexibility must be equal to the “good” ankle.
4. Strength should be equal to the “good” ankle.
Wearing your brace:
- For roughly the first week you should wear your brace every time you're standing/walking. As the ankle feels more stable you can decrease the use of your brace.
- Do not wear your brace to do your exercises.
- Wear your brace when you first return to sports especially those with a lot of stopping/starting/jumping; i.e. basketball, soccer, volleyball. You may also want to wear it when walking or running on uneven terrain.
- DO NOT get in to the habit of wearing your brace all the time. Constantly wearing your brace can actually weaken your ankle.