Ankle sprains are among the most common types of injuries encountered on a daily basis by anyone who has experienced a hike on a difficult path, a soccer match on the weekends or even just from falling off a curb improperly. An injury of such type is caused by excessive rolling of the foot inwards causing a strain or tearing of the ligaments on the outer part of the ankle, which is immediately followed by swelling and pain.
Fortunately, a majority of ankle sprains have an excellent prognosis if treated properly, and physiotherapy is at the heart of such treatment. This is how the process goes:
Initial Assessment of the Injury
It is important to note that not all sprains are equal and they are usually classified by the severity of the damage into grades 1-3, where grade 1 means some ligament stretching and grade 3 means a complete tear of the ligament. Such classification is vital for the determination of the duration of the treatment process – mild sprains could recover in two weeks, but the more serious ones may require several months to fully settle.
The Early Phase: Calming Things Down
During the first several days, the focus of the treatment plan will be aimed at alleviating the swelling and providing protection for the joint. This is when the well-known rest, ice, compression, and elevation technique is applied, though according to the latest guidelines, gentle movements may also be recommended far sooner than in the past. Prolonged immobilization of the joint may only harm the healing process and increase the stiffness. The physiotherapist is likely to introduce gentle range of motion exercise right away, if the pain permits.
Restoring Strength and Range of Motion
As soon as the pain and swelling begin to subside, the focus is shifted towards restoration of the natural range of motion. It normally involves:
- Gentle stretching for the ankle to achieve full flexibility of the joint
- Strengthening exercises for the muscles surrounding the ankle and lower leg
- Massage and manual techniques for decreasing joint stiffness
- Gentle weight-bearing activities aimed at rebuilding confidence in the ankle
It is at this stage that the patient may be tempted to stop treatment prematurely, once the pain is gone. However, it is not an advisable action, as the ligaments may appear normal long before they regain their normal strength.
Balance and Proprioception Training
It is surprising to many people just how greatly sprains affect balance. The ligaments in the ankle have sensory receptors which enable the brain to know where the joint is in space; when these ligaments are damaged the sense of position—which is called proprioception—also suffers. That is the reason why balance training, using equipment such as wobble boards, single-leg stands or other unstable surfaces, becomes so important as part of rehabilitation. Otherwise, the ankle remains more susceptible to rolling once again even though strength has come back.
Returning to Activity
The last stage involves carrying out the kinds of movements that are particular to the activity a person wishes to return to, such as running, playing a sport, or just walking without hesitation. This could include agility exercises, practice at jumping and landing, or movements that are specific to the sport. A physiotherapist is able to decide when someone is actually ready, instead of depending on guesswork or on how confident the ankle seems on a particular day.
Why Professional Guidance Matters
A large number of people attempt to look after ankle sprains by themselves, and although in some instances minor cases can be managed without any formal treatment, physiotherapy provides a organised approach which lowers the chance of long-term instability, chronic pain, or further sprains. Moreover, a physiotherapist is able to identify other problems, such as weakness in some other parts of the leg or bad movement patterns, which may have played a role in causing the injury initially.
If an ankle sprain is not getting better as you would expect, or if you’ve previously sprained the same ankle more than once, it might be a good idea to have it properly assessed. It is often the case that full recovery is achieved not by simply waiting for the pain to go away but by tackling the underlying cause.