Sprained ankles occur during many sports, including walking, hiking, running, football and netball. 

Perth Physiotherapy and Sports Injuries Centre can help you with the diagnosis and treatment of sprained ankles.


CAUSES OF SPRAINED ANKLES


Under-training 

During training, our body adapts to the increased load of the activity by thickening and strengthening tissues to cope with the increased strains. If a tissue such as the lateral ankle ligament is heavily or repeatedly loaded, for example when playing football or netball but has not had enough training to allow it to cope with these loads, the ligament may tear. An example would be the office worker who plays football at the weekend but has not trained during the week.

Ankle painOver-training

Our body adapts to the increased load of training by thickening and strengthening tissues to cope with the increased strains. If a tissue such as the lateral ankle ligament is heavily or repeatedly loaded without enough time to strengthen, it will break down and may develop tears. Over-training and over-use occur in repetitive sports such a football and over zealous training in any other fast moving or heavy loading sport.

Over-load

When our lateral ankle ligaments are properly trained and conditioned, they are strong and resilient. When there is a sudden strain such as unexpectedly rolling the foot inwards, stressing the ligament with a load greater than it can cope with, it will pull apart creating micro tears which become inflamed as they attempt to repair. Most tears are partial tears, known as sprains but sometimes the ligament will completely tear, known as a rupture. Overload injuries often occur playing tennis, squash, during all football codes and athletics and are due to:-

  • Inadequate warm up

  • Inappropriate training or conditioning

  • Faulty biomechanics such as weakness, poor muscle flexibility and joint stiffness

  • Previous and now chronic injury

The Physiotherapist will identify and correct any factors which have contributed to the development of the injury.


SYMPTOMS OF SPRAINED ANKLE


There may be stiffness and ache in a gradual onset over-use injury and severe pain with an acute tearing injury. Generally pain and stiffness is mild initially with a slow onset training injury and sudden, strong pain occurs with more widespread tears and inflammation. The more rapid and severe the onset, the greater the damage and inflammation.


DIAGNOSIS OF SPRAINED ANKLE


The diagnosis of a sprained ankle and the choice of treatment will need to be made by a qualified Physiotherapist. A thorough examination is sufficient to diagnose the type and degree of ligament tear. Ankle ligament tears may be complicated by cartilage damage, subchondral bone fractures and subtalar capsulitis with other investigations such as an ultrasound scan, arranged if extra information is required.


TREATMENT OF SPRAINED ANKLE


Sprained ankles heal best when treatment has begun as soon as practical following injury. The sports person must immediately stop the sport and avoid any movement which produces the pain. In the case of sudden onset pain the RICE protocol should commence. This is:-

  • Rest:                  Rest from aggravating movements to reduce further bleeding and injury.
  • Ice:                    Real ice wrapped in a wet towel and applied to the injury for thirty minutes every two hours.
  • Compression:  The ankle may be bandaged to reduce swelling but not during sleep.
  • Elevation:         The leg may be elevated to a 45 degree angle to drain swelling.

Medications

Pain killers may be needed initially and anti-inflammatories may be used after 48 hours when bleeding has stopped.

Advice regarding

  • The injury diagnosis
  • Anti-inflammatories and pain killers
  • Compression bandaging
  • Degree of loading required when walking

Direct Physiotherapy Treatment

  • Icing
  • Ultrasound and other electrotherapy
  • Stretches
  • Soft tissue treatment
  • Joint mobilisation
  • Exercises to regain strength, movement and proprioception

Physiotherapy Management of return to sport

  • Correction of biomechanical anomalies
  • Technique modificationTechnique modification
  • Provision of orthotics and footwear advice
  • Providing a return to sport plan

Management may require the use of crutches or a walking stick to reduce the load on the ligament. As the injury begins healing, the Physiotherapist will advise a graduated return to exercise without an increase in symptoms. Depending on which tissues are injured there will be stretches, strengthening and mobility exercises to return full function and coordination, to reduce the chance of the injury recurring.

In the event of a severe injury where Physiotherapy is not appropriate, the patient will be referred directly to a doctor or appropriate professional for further investigation and treatment. In the event surgery is required, Physiotherapy rehabilitation will be arranged afterward.


PROGNOSIS OF A SPRAINED ANKLE


Sprained ankles recover well with Physiotherapy management. Full recovery may take between one and six weeks depending on the extent of the injury. The goals of treatment are to achieve the best quality of healing with a pain free, full range of movement with normal function, so there is a minimal likelihood of a recurrence in the future.

Phone now on (08) 9481 7677 for a Physiotherapy assessment at Perth Physiotherapy and Sports Injuries Centre and we will tell you how we can help you.

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