Ankle sprains are common injuries that occur when ligaments are stretched or torn. The ankle sprain is the most common athletic injury. Nearly 85% of ankle sprains occur laterally, or on the outside of ankle joints. Sprains on the inside ligaments are less common. Many sprains occur when participating in sports, or by twisting the ankle when walking on an uneven surface. Some individuals, due to their biomechanics , are more prone to ankle sprains.
 

anatomy

The ankle joint is made up of three bones. The bones are called the tibia, fibula, and talus. These bones form a socket in which the ankle joint moves.

The tibia, fibula and talus are connected to each other by ligaments. Think of ligaments as thick rubber bands that hold bones together so that joints are stable and function properly. When an ankle is sprained, a ligament is stretched, partially torn or completely torn. Muscle and tendon structures surround the ligaments. These structures provide motion of the ankle joint for walking and running. Blood vessels, nerves and skin overlie the ligaments and tendons. The ankle joint moves the foot upward and downward. Just below the ankle joint is a ball and socket type joint that allows inward and outward motion. This is known as the subtalar joint

symptoms

Ankle sprain symptoms vary depending on severity. Often, the ankle Is tender, swollen and discoloured. The ankle can be quite painful to touch. Walking is usually hampered and may become difficult depending on the severity of the sprain. A feeling of instability may occur, especially in severe ankle sprains when ligaments are torn. Ankle sprains are classified by "types" and range from mild to moderate to severe. Type I ankle sprain, the least severe, occurs when ligament fibres have been stretched or slightly torn. Type II sprain occurs when some of these fibres or ligaments are completely torn. Type III, the most severe, occurs when the entire ligament is torn and there is significant instability of the ankle joint. Fractures of the ankle bone or outside the foot bone may be present. Fractures require immediate diagnosis and attention for appropriate treatment.

WARNING! IF YOU ARE IN ANY DOUBT THAT THE ANKLE MAY BE FRACTURED THEN SEEK MEDICAL ATTENTION IMMEDIATELY!

treatment in the acute phase

 

P - R - I - C - E

Protection - Your ankle may be splinted, taped or braced to prevent further injury.
Rest - You should rest from all activities that cause pain or limping. Use crutches/cane until you can walk without pain or limping.
	Ice - Place a plastic bag with ice on the ankle for 15-20 minutes, 3-5 times a day for the first 24-72 hours. Leave the ice off at least 1 1/2 hours between applications.
	Compression - Wrap an elastic bandage from the toes to mid calf, using even pressure. Wear this until swelling decreases. Loosen the wrap if your toes start to turn blue or feel cold.
Elevate - Make sure to elevate the ankle above heart level (hip level is acceptable during class).

to restore normal function

WARNING! EXERCISES SHOULD NOT HURT. IF THEY DO, STOP!

Range of Motion Exercises
Help you regain normal ankle motion.

Technique:

Sit with your knee straight and hold the foot position as long as possible. Do as frequently as possible for the first 3-10 days.

Pullback Flex your foot back toward your body.

 

Flexibility (Stretching) Exercises
Loosen tight leg muscles. Tightness makes it hard to use stairs, walk, run and jump and will put extra stress on the ankle..

Technique:	Hold each exercise 20seconds at a gentle stretch. Do not bounce!
Frequency:	6-10 repetitions/exercise, 5-7 days per week

Calf Stretch   Basic:  Sit with your knee straight    and towel looped   around the ball of your foot. Slowly pull back until you feel your upper calf stretch.

Calf Stretch    Advanced: Once you can stand, try stretching with   your hands on a wall. Place the injured foot behind the other with your toes pointing forward. Keep your heels down and back leg straight. Slowly bend your front knee until you feel the calf stretch in the back leg.

Heel Stretch    Basic: Sit with your knee slightly bent. Loop a towel   around the ball of your foot. Slowly pull back until you feel a stretch in the lower calf and heel.

Heel Stretch    Advanced: Once you can stand, try placing your   injured foot behind the other with your toes pointing   forward. Keeping your heels down, slowly bend your back knee until you feel a heel stretch in the back leg.

 

strengthening exercises

Strong leg muscles help the ligaments hold the ankle together.

Frequency:

Three sets of 20 repetitions, 5-7 days per week

Front of Shin   Basic - Push Out With your foot flat on the floor, push it outward against a wall, file cabinet or bookcase. Hold for three seconds.

Front of Shin   Advanced - Band Tie the band to a desk or dresser. Sit with your foot and knee in line and loop the band over the outside of your foot. Push your foot out against the band.

Inner Shin   Basic - Push In With your foot flat on the floor, push it inward against your other foot. Hold for three seconds.

Inner Shin   Advanced - Band Tie the band to a desk or dresser. Sit with your foot and knee in line, and loop the band over the inside of your foot. Push your foot in against the band.

Front of Shin   Basic - Push Up Place the heel of your other foot on top of the injured one. Push down with the top heel while trying to push up with the injured foot. Hold for three seconds.

Front of Shin   Advanced - Band Tie the band to a desk or dresser. Sit with your leg straight and loop the band over the top of your foot. Slowly pull your foot back against the band.

 

balance exercises

An ankle sprain can decrease your ability to balance on that foot and makes it easier to roll the ankle again. As soon as you can stand without pain, try the balance tests below. If you can't balance for ten seconds without wobbling, practice that level every day until you can.

 

Technique:	Balance on your injured foot for ten seconds, do a least 6 repetitions per day.
Goal:	Stand 60 seconds without losing your balance, then move to the next level.

Level 1 - Arms out to your side, eyes open   Level 2 - Arms across your chest, eyes open   Level 3 - Arms out to your side, eyes closed   Level 4 - Arms across your chest, eyes closed

WARNING do the above exercise with someone in attendance who can help you if you lose your balance!

To further improve proprioception consider a wobble board

Wobble boards- Designed to improve proprioception these devices used as per the manufacturers instructions will improve the connection between the brain and the injured nerve fibres in the ankle. A must for quick rehabilitation of a sprained ankle especially if its a repeat injury. Confused? E mail our specialist for advice!

 

 

Bracing Injured ligaments can take up to 16 weeks or more to heal. An ankle brace helps protect the ligaments not only during recovery but also when returning to sport or exercise activities.

to help prevent injury

Bracing- Proprioception (where the brain knows where the foot is) is markedly decreased after an ankle sprain. Also the affected ligaments are weakened and as a consequence will never regain their full strength (maximum 90%). Therefore it is a good idea to brace the affected ankle when starting back into your chosen sport. We have a range of braces that are sport specific allowing you maximum comfort when wearing the shoes designed for your sport.

Have a look at the products on offer by going direct to the online store. Information on appropriate bracing is straight forward but further advice can be accessed by emailing a specialist free of charge!

Check the online store for our ankle rehab package, including all of the above at a discounted package rate.

*please see terms & conditions
   

returning to normal sporting activity

The goal of rehabilitation is to return you to your sport or activity as soon as is safely possible. If you return too soon you may worsen your injury, which could lead to permanent damage. Everyone recovers from injury at a different rate. Return to your activity is determined by how soon your ankle recovers, not by how many days or weeks it has been since your injury occurred.

You may safely return to your sport or activity when, starting from the top of the list and progressing to the end, each of the following is true:

You have full range of motion in the injured leg compared to the uninjured leg.

You have full strength of the injured leg compared to the uninjured leg.

You can jog straight ahead without pain or limping.

You can sprint straight ahead without pain or limping.

You can do 45-degree cuts, first at half-speed, then at full-speed.

You can do 20-yard figures-of-eight, first at half-speed, then at full-speed.

You can do 90-degree cuts, first at half-speed, then at full-speed.

You can do 10-yard figures-of-eight, first at half-speed, then at full-speed.

You can jump on both legs without pain and you can jump on the injured leg without pain.

 

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