Ankle sprains are a very common injury that can occur for a variety of different reasons. In this piece, we’re going to discuss ankle sprains, how they happen and what you can do about them. So keep reading to learn about ankle sprains.
What is an ankle sprain?
An ankle sprain happens when the ankle rolls, twists or is forced beyond its normal range of movement this can result in damage to the ligaments, tendons and bones in the ankle.
Ankle sprains are often referred to as a rolled or twisted ankle they are among the most common sports and musculoskeletal injuries despite this they are often poorly managed. This poor management means the ankle remains loose and weak after the injury and often gets sprained again.
The most common form of ankle sprains are inversion sprains where the inside of the foot is over extended underneath the body (see picture). This type of sprain results in pain and potentially swelling and bruising on the outside of the ankle, normally in the area around your malleoli (the boney lump on the outside of your ankle). Eversion and high ankle sprains are also possible but less common examples of ankle sprains, for the purpose of this blog we will be focusing on inversion sprains.
What causes an ankle sprain?
There are a number of factors that can lead to an ankle sprain and sometimes a combination of reasons can cause one.
Among the most common reasons ankle sprains occur are:
Uneven or slippery ground
Fall and stumbles
Poor footwear
Weakness and ligament looseness from previous sprains
Sporting sprains from changes in direction or trauma suffered during sport
Foot type and walking running/technique
What are the symptoms of an ankle sprain/what does it feel like?
To answer this, we’ll first give you a quick anatomy lesson.
The outside of the ankle has three primary ligaments that keep it stable – the anterior-talo fibular ligament(ATFL), the calcaneo-fibular(CCF) ligament and the posterior talo-fibular ligament(PFTL) (see the diagram below).
There are also the peroneus longus and peroneus brevis tendons passing through this area muscles whose job it is to keep the foot stable when we walk. All of these ligaments, the bones they attach to, and the peroneal tendons can all be damaged in an ankle sprain.
When the ankle is forced beyond its normal range of movement in an ankle sprain these structures can become strained, torn or ruptured. The most common damage in this scenario is to the ligaments of the ankle with the ATFL most commonly injured followed by the CCF ligament. When this happens, we often get bruising, swelling and a significant amount of pain.
To assist us in working out how damaged your ankle is our clinicians often use the Ottawa ankle rules which are a good guide as to whether a bone may be broken or not.
Why do i keep spraining my ankle?
If you are suffering repeated ankle sprains it could be for a few reasons but some of the more common reasons are:
Weakness and looseness from un-rehabbed previous injuries
Poor shoes
Poor technique during certain sporting movements
A foot type that lands on the outside of the foot and remains supinated(rolled out) during walking and running. This is most common is high arched or Cavus feet.
If you are finding that you are getting repeated ankle sprains it is really important to try and get to the bottom of why and address that cause. If you do not do this, it is likely that you will continue to suffer the sprains and experience chronic ankle pain and arthritis in later years.
How do you diagnose an ankle sprain?
Like most musculoskeletal injuries, ankle sprains come in more and less severe cases. To help us determine how much damage has been done to an ankle during a sprain we will often refer you for an xray, ultrasound, CT or MRI scan, depending on what we feel is most appropriate. This will help accurately work out how much damage has been done and what treatment is required to help you get better.
How do you treat an ankle sprain?
Once we have determined how severely your ankle has been damaged the next step is putting together a treatment plan to help you get better. The main focus of this is initially on pain management. We put together our treatment plans based on the treatments from the acronym POLICE. POLICE has replaced RICE, and stands for:
P- Pain management
O- Optimal Loading(relative rest)
I – Ice
C – Compression
E- Elevation
The goal of these early treatments is to manage pain and reduce loading while the body begins its early phase of healing.
This is a great time to come and get assessed as we can help organise scans and a moon boot if needed.
The next phase once pain and swelling are beginning to reduce will focus on gradually recapturing range of motion and movement in the ankle.
Once full range of motion has been restored, we set about trying to rebuild strength and stability in the ankle and targeting a return to sport and normal activities. This large step is crucial in making sure that the risk of reinjury is managed. These steps in the recovery will be helped by potentially also using a combination of other treatment options including:
Custom exercise programs
Custom rehab programs involve strengthening and conditioning programs made up of stretches, exercises and other activities tailored to suit your exact level of ankle injury, age, and fitness.
We choose specific activities, exercises and stretches to help you recover from your ankle injury with the aim of making the injured ankle stronger, more flexible and highly durable. We will also build and choose exercises specific to the sport and activities you are hoping to get back to.
Our custom programs focus on a long term approach to make sure you not just recover from your current injury but minimise the risk of any recurrence of the injury or ongoing issues. We utitilise a free App called physitrack so that you get a full video library of exercises to work from at home.
Moon boots
In more severe ankle sprains it may be necessary to give the foot and ankle significant rest and often the best way to do this is by wearing a Moon boot.
These fitted boots allow the ankle to be braced and rest while healing and unlike plaster casts they can be easily removed for showering and sleeping.
Orthotics
Orthotics are mainly used for ankles that are chronically weak and less so for a freshly sprained ankle. Orthotics can be a good option along with exercises to create stability and reduce the likelihood of future sprains.
Prolotherapy
Prolotherapy or proliferation therapy, is a form of injection therapy used to stimulate a healing response to injured tissues. It is a type of regenerative injection therapy where the solutions injected aim to stimulate the body’s natural healing processes to form new tissues such as muscle, ligament, tendon and fascia. The substances injected consist of tailored amounts of glucose (specifically dextrose) and local anesthetic mixed. This results in healing and a tightening of ligaments. Learn more about prolotherapy here.
K-Laser treatment
K laser can be used to help stimulate rapid healing and recovery from injuries like ankle sprains we have a series of blogs available on K laser treatment and help it can help in this scenario. Learn more about K-laser therapy generally here and about how it may help with an ankle injury here.
Ankle bracing and taping
Ankles that have been strained and sprained can be supported using taping and bracing. We offer a variety of braces and taping techniques to ensure that you’re comfortable and your ankle is going to heal properly.
How long will an ankle sprain take to get better?
This is totally dependent of the severity of the injury some minor sprains can be fully recovered with days or a week; more severe strains can require surgeries and result in problems for several months. The most common range for recovery is normally around 2-6 weeks though.
Have you hurt your ankle?
Whether you’ve recently sprained your ankle, you have chronically weak ankles or you are experiencing some sort of pain and/or discomfort in your feet and/or lower limbs, at Hurst Podiatry, we’re here to help.
Hello. I suffered a ankle sprain in March and Its been 3 months and I haven’t recovered yet. Can You tell me what is the problem and how am I able to recover it asap?
Hi there! Ankles are quite complicated and you could be suffering a number of different problems after your sprain. We would suggest getting the ankle assessed properly. Whoever does this for you could then organise scans to find out what is wrong and put together a treatment plan for you. If the pain is still there 3 months later you will definitely want to follow this up to avoid long term problems!
Hello. I suffered a ankle sprain in March and Its been 3 months and I haven’t recovered yet. Can You tell me what is the problem and how am I able to recover it asap?
Hi there! Ankles are quite complicated and you could be suffering a number of different problems after your sprain. We would suggest getting the ankle assessed properly. Whoever does this for you could then organise scans to find out what is wrong and put together a treatment plan for you. If the pain is still there 3 months later you will definitely want to follow this up to avoid long term problems!