At PMPP we often have clients presenting with ankle sprains, often related to sudden changes of direction involved in sports such as soccer, AFL and netball, and also from tripping over when running or walking.
The most common type of ankle sprain is an inversion sprain, occurring when the outside ligaments of the ankle are over stretched and torn. For more information on acute ankle sprains, how physios treat them and how they can be prevented, check out our previous blog post on acute sprains here http://www.portmelbournephysio.com.au/ankle-sprains/.
Unfortunately, we often see clients presenting with reoccurring ankle sprains, as their ankle ligaments and muscles have become weak often from not following treatment protocols and inadequately rehabilitating their first acute ankle injury. They may also have ongoing stiffness in the ankle joint and reduction in balance, known as proprioception, both of which make you more susceptible to sustaining another sprain.
Severity of Ankle Sprains
Rehabilitation of ankle sprains depends on the severity of the injury, with ankle sprains graded as follows:
Grade 1: Mild sprain – slight tearing and mild tenderness around ankle
Grade 2: Partial tearing of ligament and moderate tenderness
Grade 3: Severe – complete tearing of ligament, significant tenderness
Your physio will use this grading system to determine an appropriate rehabilitation program for you, and the time frames for return to sport and activity. The recovery process depends on which grade of injury has occurred. A grade 1 can typically take between 2-4 weeks, a grade 2, up to 3 months and a grade 3 up to 6 months. In rare circumstance, surgery may be required for severe sprains.
Rehabilitation post ankle sprain
Once the acute phase of treatment (involving RICE and gentle physiotherapy) has passed, your physio will commence you on a program to improve joint range of motion, muscle strength around the ankle and balance. Most of this work will be done by you at home or in the gym, with only the occasional session with your physio to progress your program.
Your rehabilitation program will include:
- Mobilisation techniques and provision of range of movement exercises to reduce stiffness in your ankle joint and return you back to the same flexibility as the other ankle.
- Massage to decrease any residual swelling and break down any scar tissue that has developed around the ligaments.
- Teaching you self taping techniques to minimize stress on the ligaments when playing sport and reduce your risk of injury. You may have noticed that many professional athletes (AFL and tennis) preventatively tape their ankles for every match, as time out from their sport can be very costly!
- Developing a progressive strengthening exercise program based on the grade of injury and recovery time frames, in order to rebuild the ligaments and muscles around the ankle. This may include:
- Calf, peroneal and intrinsic foot muscle strengthening exercises
- Proprioception (balance) exercises ie standing on one leg
- Developing a return to running program, progressing from walking, jogging, running, sprinting, change of direction
- Agility and power exercises to get you back to your previous level of exercise
Other things to consider
At PMPP we pride ourselves on having an holistic approach to the treatment of musculoskeletal injuries. For this reason we may refer you to other health professionals to assist in your recovery. This may include:
- An assessment with a podiatrist at Up and Running Podiatry, to ensure the cause of the sprain wasn’t because of poor foot biomechanics and assess the need for orthotics
- Referral for X-ray or MRI scans should your injury not be progressing as expected
- Referral to a sports physician at Olympic Park Sports Medicine Centre for other medical treatments such as anti-inflammatories or cortisone injections. In severe cases the sports docs will be able to refer on to an ankle surgeon.
- Referral to Chris White at Go Run Australia to assist with any running technique, biomechanical or over-training issues http://www.gorun.com.au
Once acute swelling and pain has settled post ankle sprain, it’s easy to think that your ankle is now back to 100% and forget to follow your rehabilitation program. However, if you do it right the first time, the chance of having a reoccurring injury is dramatically reduced, and the length and amount of treatment required is much less.
For more information or to chat to one of the physios about your ankle rehabilitation call us on 96817255 or contact us here http://www.portmelbournephysio.com.au/contact-us/