The Sports Series: Sprained ankle

Ankle sprain is a common injury that many runners, netball, basketball and soccer players have experienced previously.

What is an ankle sprain?

An ankle sprain happens when one of the ligaments most likely the anterior tibiofibular ligament (ATFL) in the outer side of the ankle is overstretched from the foot being rolled outward.

Gotham Footcare. (n.d.). Ankle Sprain [Photograph]. Gotham Footcare.

The severity of an ankle sprain depends on the extent of the injury within the structures in the foot.

It is wise consult a professional Physiotherapist to assist you in diagnosing the severity of your ankle.

Source: Adapted from Maughan KL, "Ankle Sprain," UpToDate, version 14.3, and Ivins D, "Acute Ankle Sprain: An Update," American Family Physician (Nov. 15, 2006), Vol. 74, No. 10, pp. 1714–20.

Treatment for acute ankle sprain

For the first 24-48 hours of the injury, the RICE protocol will help to decrease pain and swelling and also protecting the ankle from further injuries.

R- Rest (avoid any pain provoking movements)

I- ICE (this will assist in decreasing swelling and provide pain relief)

C- Compression (wrap an elastic bandage around the ankle to prevent further swelling)

E- Elevation (Best to have the ankle elevated above the heart for fluid drainage)

Range of motion rehabilitation

After the acute stage has passed your Physio will re-assess you and generally you will begin by restoring your range of motion.

Some simple but effective ones to start of with are:

• Drawing the alphabet with your toes, really encouraging movements in all directions (see image on left). Go through the alphabet 2-3 times

• Towel curls- In a seated position with a towel under your feet, scrunch your toes to draw and push the towel backward and forward (see image on right) perform for 3-5mins

Ankle Alphabet Towel Curls

Dancing Feet. (n.d.). Ankle Alphabet [Image]. Dancing Feet.

The Chiropractic health centre. (n.d.). af-towel-curls [Image]. The Chiropractic Health Centre

Strength, proprioception and balance rehabilitation

The last stage of the ankle sprain rehabilitation is to begin working on your strength, proprioception and balance. Its important to discuss with your Physio regarding the timing to start on the next step after range of motion exercises. Generally a good indicator is when you are able to stand pain free without swelling. Avoid starting these exercises without having consulted a Physio especially if you were not able to do them before the injury.

Stretching and strength Balance & Proprioception

Active Care Physiotherapy Clinic. (n.d.). Ankle foot exercises [Image]. Active Care Physiotherapy Clinic

Performance health Academy. (2013, October 31). Ankle muscle activation during exercises on different unstable surfaces [Image]. Performance Health Academy.

Note that the number of repetitions and intensity that you may require will be based on your Physiotherapist's recommendations.

But a general rule for the following exercises are:

Stretching: hold the stretch for 15-20 seconds, repeat 2-3 times

Strength: 8-12 reps 3 sets

Balance: Perform each exercise for 2-3 mins each, a feeling of soreness in the ankles is considered normal as the intrinsic muscles are being worked.

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References:

• Active Care Physiotherapy Clinic. (n.d.). Ankle foot exercises [Image]. Active Care Physiotherapy Clinic. https://sites.google.com/site/activecarephysiotherapyclinic/ankle-foot-exercises In-text citation

• Dancing Feet. (n.d.). Ankle Alphabet [Image]. Dancing Feet. http://dancingfeet-jfaeth.blogspot.com/2010_07_01_archive.html

• Gotham Footcare. (n.d.). Ankle Sprain [Photograph]. Gotham Footcare. https://www.gothamfootcare.com/services/ankle-sprain

• Performance health Academy. (2013, October 31). Ankle muscle activation during exercises on different unstable surfaces [Image]. Performance Health Academy. https://www.performancehealthacademy.com/ankle-muscle-activation-during-exercises-on-different-unstable-surfaces.html

• The Chiropractic health centre. (n.d.). af-towel-curls [Image]. The Chiropractic Health Centre. https://www.chiropractor.co.za/stable-foot-ankle/af-towel-curls/