Eramosa Physiotherapy: Client
Education for ...
“Ankle Sprains”
“Ankle Sprains”
What is
an ‘ankle sprain’?
-
a sprain refers to damage that
occurs to ligaments after they have been put under a certain amount of stress
-
ligaments are meant to
withstand forces placed on a particular joint in the body and provide
mechanical stability during activity
-
ankle sprains most commonly occur to the
ligament(s) on the outside or lateral aspect
of the ankle, but can also occur to the ligaments on the inside or medial aspect of the ankle
-
sprains can be graded from 1 to
3 depending on the amount of damage to a ligament
What
are other injuries that can occur at the ankle?
-
Avulsion Fractures
-
Stress fractures
-
muscle strains
-
Achilles tendonitis
-
Neuropathies
How do
ankle sprains happen?
-
A lateral ankle sprain, the most common of all ankle sprains, occurs
when
o the
foot is forcibly turned inwards
o landing
from a jump
o stepping
off a step onto the side of the foot
o landing
on uneven surfaces with a twist
-
a medial ankle sprain does not occur as often as a lateral sprain
because the foot is stronger and more stable along the inside of the ankle
joint but can be sprained by:
o a
high force exerted that forces the foot outwards
-
a high ankle sprain may occur in people who
o participate
in sports involving boots (hockey and skiing), as well as football, rugby,
wrestling, and lacrosse
o a
high ankle sprain occurs to ligaments that hold the two leg bones together
(tibia and fibula) at the bottom of the lower leg
What
will aggravate a sprained ankle?
-
Depending on the grade of tear,
walking may cause pain
o Grade
one: no/little limp
o Grade
two: limp and unable to put weight through the foot
o Grade
three: unable to put weight through the foot and the leg of the injured ankle
-
The injured ligament is tender
and painful when touched
What
will relieve a sprained ankle?
-
Depending on severity, not
walking on it
-
No touching or pressing on the
ligament
-
Wrapping the ankle as soon as
the injury has happened with a tensor band to help prevent much swelling from
pooling in the ankle complex/ foot
-
Recognition of injury and
initial treatment (see below)
-
Physiotherapy
How
will I know if I’ve sustained an ankle sprain?
-
*note: depending on the grade,
severity of signs and symptoms will vary:
o swelling
within the first two hours
o tenderness
over ligament
o a
feeling of instability with standing and/or walking
o bruising
o loss
of range of motion (movement)
What
long-term issues may arise if this injury is not dealt with?
-
After you’ve sprained an ankle,
the recurrence rate of sustaining another sprain is as high as 70% (1), so
treatment is vital for maintaining function
-
Chronic ankle instability: a
sequence of ankle sprain injuries that lead to residual symptoms and decreased
physical activity abilities (i.e. running)
-
Altered gait (walking)
mechanics
Treatment:
The natural history of this injury or prognosis for ankle sprains is proportional to the severity and
grade of injury. Thus, a grade 2 injury
takes longer to heal than a grade 1.
-
Typical treatment protocol:
o
o In
the subacute healing stage, the goal
of treatment is to eliminate residual swelling, obtain complete pain-free range
of motion in the movements of the foot, and begin strengthening muscles
surrounding the ankle to help with function
o In
the final stage of healing, walking
with a normal gait pattern is promoted, further strengthening is encouraged,
balance exercises are incorporated into a home exercise program to ensure safe
and effective walking, stair-climbing, running etc...
o It is recommended that after
one sustains an ankle injury, braces should be worn to prevent further
injury/ies when performing leisure activities; whether the activity is a
recreational or competitive nature (2)
-
Advanced treatment:
o development
of balance over time and return-to-sport activities are incorporated toward the
end of treatment to help you get as close to pre-injury level as possible
o Return-to-sport
activities may not be necessary for all patients
What
can Physiotherapy do for this injury?
A registered physiotherapist will help arrange
and follow through with a treatment plan that works best for you. With their extensive knowledge regarding the
use of manual therapy to help increase range of motion and decrease pain used
in conjunction with modalities, such as a TENS machine, to further aid in
decreasing pain, you will notice results after one visit. Particular stretches and exercises will be
prescribed as a part of a home exercise program to help you help yourself get
the results you are looking for in no time.
References:
1.
Hubbard TJ, Hertel. Mechanical Contributions to Chronic Lateral
Ankle Instability. Sports Med.
2006;36(3):263-267.
2.
McKay G, Cook J.
Evidence-based Clinical Statement: Physiotherapy management of ankle
injuries in sport [Internet]. Australia:
Australian Physiotherapy Association, 2006 [cited 2012 March 25]. Available
from: www.physiotherapy.asn.au
