The dreaded ankle sprain.
My patient came into the clinic having stepped off a curbside without thinking. She simply landed the wrong way as she came down. She was met with excruciating pain and was left sitting on the curb as she caught her breath and came to terms with what had happened. A simple injury that can result in significant pain. She felt the ankle swell immediately and hobbled to her car before driving home.
Once home she put her foot up and put the ice pack on. She also bought a compression ankle strap.
She then asked herself the question- do I need to do anything about this?
Personally I have had many ankle sprains before (too many to count!), most of them happening on the basketball court. In America it is estimated there are 25,000 ankle sprains PER DAY and they are the most common sports injury accounting for up to 20% of all sporting injuries.
In this post you will learn about the steps you should take after an ankle sprain to start the road to recovery!
Rest, Ice, Compression, Elevation and Referral (RICER)
Just like my patient most of you will be aware of RICER and will automatically rest from your activity and put it up with ice if you can. This is a great first step in helping settle any pain and control some of the internal swelling and bleeding from the injury. Once you’ve completed the RICE part- you should consider if you need a referral to a health professional.
Should I go to the Hospital?
If there is suspicion of a fracture then one should go to the hospital and get immediate help and assessment.
But what are the signs of a potential fracture?
Firstly it’s likely that you will be unable to put any weight through the foot and will be hopping around. Whilst not all fractures respond this way it’s often a clear sign when you aren’t able to put weight on it at all.
Also you will likely have some very focal points of pain and tenderness over the bones. If you have come down hard off a jump or something high your chances of fracture or other injury are higher. If you are unsure I would encourage you to get it checked out at the Hospital or see your GP ASAP.
Should I go and see the Doctor?
At a recent GP workshop we ran, some of the doctors reporting seeing at least a few ankle sprains per week. Ouch!
In their practice a GP will be able to assess your ankle and also help to determine whether a scan is required. They will push and feel around specific bones and ligaments to help in that decision. They will also guide you with the early stages of the recovery and help with appropriate referrals to physiotherapists or specialists if required.
Should I go and see the Physiotherapist?
If you decide to bypass the Hospital and GP you might end up deciding whether to see a physiotherapist.
And I might be bias, but I think all ankle sprains should be seen for assessment to determine the exact nature of the injury and the structure’s involved. One of the specialist sports physiotherapists I know once said “It’s never just an ankle sprain.” and I think this is true in many cases!
It is also important to be given the required exercises to regain your full movement and strength.
Personally I feel the rehabilitation and treatment I went through in high school was not good enough and resulted in many future injuries and now unstable ankles.
So what happens if you leave a sprained ankle untreated?
Unfortunately people are often left with dysfunctional ankles, rarely returning to full capacity.
After such an injury there is swelling and inflammation. This coupled with the lack of use cause the ankle joint and calf to become stiff and tight. If this movement is not restored people will have issues with going up or down stairs, pointing their toes or sometimes even walking.
The strain to ligaments also means the body’s natural support system is not as good. The swelling also causes the joint to lose its awareness. Both of these mean the ability to balance and stabilise on this ankle is greatly compromised.
The result of both of these things?
A stiff and uncomfortable ankle which is weaker and more prone to future injury. Not a good recipe!
So check the above but always consult your own medical professionals to see if it applies to you personally.
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