Hayden Talks Ankle Sprains;
“It’s just an ankle sprain?”
Wrong. So often we see people presenting 3-6 weeks after they have rolled their ankle. The problem with this is often you are walking around with 50% less range of motion. Think going down stairs without being able to flex your ankle. You will often ‘crab down’ or work harder with the other leg.
This causes compensatory patterns as well as stress in other areas of the body. Patients are often amazed when I show them a simple knee to wall test and it’s 50% less than the other side. This is the “AHAA” moment when they realize they should’ve come 3 weeks ago. It often explains their other symptoms.
The other issue with presenting late is a lot of the improvements are much easier to get in the first few weeks of treatment. At 6 weeks sometimes we cannot restore 100% of the range of motion. We definitely struggle at 6 months.
We know that presenting to physio in the first 2 weeks give you improved outcomes. The other interesting pieces of evidence suggest that we have a loss of proprioception up to 12 months after an ankle sprain.
Proprioception is the bodies ability to know where it is in space. Basically, the signals from the ankle to the brain, which allow us to make fine tuning adjustments to where our foot lands.
This ability is dampened for 12 months post an ankle sprain. This increases the risk of re-rolling in the first 12 months. The good news is this improved rapidly with exercise. The other good news is that a decent ankle regime only needs 5-10 minutes twice a week to be beneficial to proprioception.
Another interesting study suggested that people with an ankle sprain are at an increased risk of tearing their ACL. Whilst we don’t know if this is because of compensatory patterns or overload it raises a very interesting point. We shouldn’t be treating ankle sprains with an apathetic attitude.
What should I do?
By no means are we saying an ankle sprain is the worst thing in the world. Yes, some people to roll, walk away and nothing else happens and life is just fine. However, a lot of people struggles 6-8 weeks later and the evidence suggests they are a massive chance of doing it again or doing something more significant.
So, even if it is a minor roll, jump in and see your physio for an assessment. Minor sprains we will often assess and see you 3-4 times over the course of 6-12 months just to upgrade programming and reduce the risk of further injury.