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ANKLE SPRAINS

Ankle sprains occur when you roll, twist, or turn your ankle in an awkward way, causing the ligaments in the ankle to be partially or completely torn. The ligaments help to stabilise the joint and prevent excessive movement. A sprained ankle is when the ligaments are forced beyond their normal range of motion. The most common ankle sprains involve injury to the ligaments on the outside of the ankle.


Depending on the severity, ankle sprains can be associated with swelling, bruising, tenderness, decreased range of motion, or difficulty weight-bearing.


Without adequate treatment and proper rehabilitation, a more severe sprain can weaken your ankle, meaning it is more likely to be reinjured. Repeated ankle sprains can lead to more long term issues such as chronic ankle pain, arthritis, and ongoing instability.


Causes

  • A fall or trip causing your ankle to twist

  • Landing awkwardly after a jump or hop

  • Walking on an uneven surface, causing the ankle to roll

  • Being stepped on or landed on by another person during sport


Symptoms

  • Immediate pain with standing and walking

  • Ongoing pain

  • Tenderness to touch

  • Swelling

  • Bruising

  • Limited range of motion

  • Instability

  • Hearing a ‘pop’ or ‘crack’ at the time of injury


The risk of spraining your ankle can be increased by participation in sports that require jumping, sharp changes of direction, or twisting of the foot. These include netball, soccer, tennis, and trail running. Walking or running on uneven surfaces also increases the risk of a sprain. If you have sprained your ankle in the past, this may place you at an increased risk of spraining it again. Especially if it was never rehabilitated properly, leaving you with poor strength, flexibility and stability. Footwear also plays a role, for example wearing high heels can make the ankle more vulnerable to injury.


Management

In the acute stages of a sprained ankle, it is important to follow the RICER protocol.


How can physiotherapy help?


Physiotherapy helps to restore full range of motion in the injured ankle. We can provide pain relief with ultrasound, ice and TENS. We provide a comprehensive exercise program targeting range of motion, strength, balance, stability and endurance. We give advice on treatment and safe exercise during recovery, aiming to get you back to your normal activities or sport as quickly as possible. We provide advice on how long you should remain off your sport and what exercises are safe to do in the meantime. We provide specific exercises tailored to your sport or activity to make sure you are ready for all the challenges that your sport entails. We also perform taping to help provide extra support or fit you with an ankle guard if appropriate, to prevent further injury.


What should my exercise program involve?

Stretching and range of motion exercises are prescribed first in order to achieve full range of motion in your ankle. Strength exercises should target the muscles of the calf, ankle and foot. Strengthening of other muscles in your lower limb such as your hip and thigh muscles may also be necessary depending on assessment findings. As your strength improves, rehabilitation then begins to focus on power, agility and speed, incorporating sport specific exercises to help you transition back to your normal sport and activities. Balance and proprioception training is also crucial in helping retrain the ankle muscles to work together and support the joint, helping to prevent future injury.


Rehabilitation exercises should be continued on a daily basis, even after your ankle starts to feel better, especially before and after physical activities to help prevent reinjury.


Tips for preventing an ankle sprain

  • Adequate warm up before exercise and sport

  • Wear appropriate footwear during sport

  • Limit wearing high heels

  • Maintain good muscle strength and flexibility

  • Work on improving your stability by performing balance exercises

  • If you have previously suffered from an ankle injury, make sure the ankle is taped or you are wearing an ankle brace while you play sport


Examples of exercises


Gastrocnemius Stretch:

  • Place hands against a wall and slowly lean forward.

  • Allow front knee to bend, but keep back leg straight with your heel on the ground.

  • Hold for 1 minute.




Soleus Stretch:

  • Slightly bend back knee.

  • Allow front knee to bend, and slowly lean forward so that your back knee moves over your toes.

  • Hold for 1 minute.




Heel Raises and Dips on a Step:

  • Begin standing on the edge of a step

  • Come up onto your toes on both feet and hold for 3 seconds

  • Then lower back towards the ground and hold in that position for 3 seconds

  • Repeat 10 times


If you are suffering from an ankle injury and would like some help or further information, please give us a call on 9875 3760, or email us at info@wphphysio.com.au. We would be more than happy to give you advice and assist you in your recovery!

You do not need a Doctors' referral in order to make an appointment with a Physiotherapist

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