Ankle sprains are a fairly common injury for athletes and even those who do not workout regularly. I see it in clinic amongst all ages and activity levels. They can also be easy or hard to recover from depending on the severity of the sprain.
A sprain anywhere in the body is damage done to a ligament. Ligaments attach bone to another bone, and they are not usually very big but can cause a lot of pain. Ligaments also take longer to heal because of the lack of a blood supply. Without a sufficient blood supply, the appropriate nutrients are not brought to the area to heal.
There are different types of ankle sprains which include:
- Lateral (most common) or the outside of the ankle caused by the ankle rolling inward and stretching the ligament.
- Medial or inside of the ankle which can be caused by rolling outward or crushing of the ligaments if a lateral sprain occurs.
- High ankle sprain is a sprain of the ligaments between the 2 bones of the lower leg caused by the foot being forced backwards and spreading those bones.
There are also specific grades or severity of ankle sprains.
- Grade I: over stretching, microtears in the ligament
- Grade II: Larger tear of the ligament but not completely torn
- Grade III: Full thickness tear of the ligament
You can also have damage done to multiple ligaments with one injury. For example, as shown above, a lateral ankle sprain can cause damage to the inside ligaments through a crushing mechanism.
Exercises:
Alphabet: Just as it sounds, pretend you have a pen between your big and second toe, write the alphabet using the ankle.
Circles: perform slow even circles in the clockwise and counterclockwise directions.
4-way ankle:
Plantarflexion: against resistance, point the toes away from body
Dorsiflexion: against resistance, bring toes up to your body
Inversion: against resistance, bring foot inward
Eversion: against resistance, bring foot outward
Single leg stance: balance on 1 leg for 30 seconds at a time repeating 3-5 times.
Squat: with knees a little more than hip width apart, bend knees as if you are going to sit in a chair, then return to standing position. Make sure your heels stay on the ground. This will improve the overall strength of the LE’s and help improve the range of motion in the ankle.
Calf stretch: with feet flat on the floor a few feet away from the wall, place hands on the wall and lean into it, again keep heels down and feel the stretch in the back of the lower legs.
Other Treatments
There are more ways to treat ankle sprains. Have you ever heard the term RICE? As in Rest, Ice, Compression, Elevation. I learned this in undergrad and PT school as the way to treat ankle sprains and other acute injuries (injuries that are sudden). It is also what doctors may still be telling patients, but it is outdated.
MEAT
The research shows the new way of thinking is “MEAT”: movement, exercise, analgesics, treatment/therapy.
- Movement: continuing to move the affected joint through its full range of motion as pain allows.
- Exercise: Performing the correct exercises, at the right time to help increase the healing process in the body.
- Analgesics: Pain relieving medications like Tylenol and other herbs and supplements to improved healing and reduce pain.
- Treatment/Therapy: PT can help along the way with other manual therapies and modalities as well as exercises to improve the injury.
RICE
This is not to say that RICE does not have its place in the treatment process.
- Rest: to an extent. Not pushing past your limits of pain and taking a break from the higher-level activities.
- Ice: Ice has been shown to help with swelling and pain relief but can also lead to decreased healing properties if used longer than 2 days following the injury.
- Compression: Helping to get rid of the swelling but can be uncomfortable to perform.
- Elevation: this can also help with the swelling in the injured joint, however movement can have the same effect.
Ankle sprains are not fun nor are they always easy to recover from. But the exercises listed will not only help following a sprain but performing them on a regular basis can help strengthen the ankle to decrease the likelihood of one occurring.