The pain of the ankle sprain
An ankle sprain occurs when the strong ligaments that support the ankle stretch beyond their limits, usually when the foot rolls outwards. The sprain can range from mild to severe depending on how much damage has been done to the ligaments.
Ligaments are strong, fibrous tissues that connect one bone to another. They help maintain the position of the joint and thus maintain the stability.
Most sprained ankles occur in the outer, lateral ligaments when the lower leg or foot is twisted outwards and can occur during many activities for example walking on uneven ground, sports or even falling.
Typical signs and symptoms include:
- Pain
- Swelling
- Bruising
- Tenderness to touch.
There may be a feeling of instability if a large proportion of the ligaments have been damaged.
There are three grades of ankle sprain:
Grade 1 / Mild
Slight stretching and microscopic tearing of the ligament fibres.
Mild tenderness and swelling around the ankle.
Grade 2 / Moderate
Partial tearing of the ligament.
Moderate tenderness and swelling around the ankle.
If the doctor or physiotherapist moves the ankle in certain ways, there is an abnormal looseness of the ankle joint.
Grade 3 / Severe
Complete tear of the ligament.
Significant tenderness and swelling around the ankle.
If the doctor or physiotherapist pulls or pushes on the ankle joint in certain movements, substantial instability occurs.
Treatment:
Almost all ankle sprains can be treated without surgery.
There are 3 phases to the conservative treatment, which may take up to 12 weeks following a severe sprain.
The initial treatment should comprise of reducing pain and swelling with RICE
- Rest from weight bearing activities
- Ice for 10 minutes to your ankle 3 or 4 times a day
- Compression in the form of a bandage may help to reduce swelling and pain but only do this on a short term basis.
- Elevation of the ankle above groin level.
Taking non-steroidal anti-inflammatory medication to assist in reducing both pain and swelling may be advisable, but you are advised to check with your pharmacist prior to starting.
The second phase must include regaining the range of movement and strength in the ankle whilst still reducing pain and swelling. Some exercises will be given to assist with this which may include some proprioception (balance) training.
Finally the last stage must be to assist with exercises, the gradual return to normal activities and sport. Some more advanced exercises will be taught including any agility drills if appropriate.
Reoccurring ankle sprains may occur if you do not allow the ligaments to heal completely. Sometimes surrounding tendons may help with stability and movement thus making it seem as though full recovery has been achieved. However if pain is still persistent at 4 to 6 weeks the chances are you are suffering with a chronic ankle sprain.
How can you help yourself to prevent re-occurring ankle sprains?
The best things to do is maintain good range of movement, balance and muscle power in the leg and ankle. Wear good supportive shoes suitable for the task you are doing.
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