Dealing with ankle sprains

As we move into winter sport the number of ankle sprains that we see starts to rise rapidly. However this common injury is also one of the most poorly managed of all sports injuries.All to often it is treated as “just a sprain” and lucky that you didn’t break anything. It is common practice for athletes to just give it a few weeks rest and then try going back to sport, however the repurcusions for not following a proper rehab program can be great. There is evidence that shows a history of ankle sprains increases your risk of an ACL. Injury. A properly constructed rehab program will reduce the risk for future injury.

There are a number of structures that are susceptible to injury during an ankle sprain. There are the lateral ankle ligaments which are the most commonly injured, however in more severe injuries the midfoot ligaments or high ankle ligaments can be affected. It is important to distinguish which ligaments have been injured shortly after a sprain because the management is vastly different, and mismanagement early on can lead to numerous issues in the long run.

If you have sustained a sprain of the lateral ligaments there are three things that need to be considered before you even think about returning to sport:1. Ankle range of motion2. Calf strength3. Proprioception / balance

The first thing to do after a sprain is to get full ankle movement back. Without proper range of motion you can’t dissipate force properly when jumping and landing, this leaves you more succeptable to another ankle injury or possibly an injury further up the chain somewhere like the knee.

The initial injury and swelling will decrease the neural drive to the calf muscles causing weakness. It is important for obvious reasons to restore strength before returning to sport. Without adequate strength and endurance of the calf complex you are not going to perform optimally and expose yourself to another injury.

After a ligament injury your sense of balance and proprioception will be thrown out. As it can take upwards of 9 months for ligaments to heal and in severe cases they may not heal as short as it initially was, it is important to work hard on your balance and proprioception. This work needs to be progressed over a number of months, and whilst we can get you back to sport a little sooner by strapping your ankle it is important that this stability work is progressed then maintained for upwards of 9 months.If you have sustained an ankle injury and would like help progressing through a proper rehab to decrease injury risk and optimize performance reach out and one of our physiotherapists will be able to help you out.

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