“Just a rolled ankle” - The Do’s and Don’ts of Ankle Sprains

A study found that in the 1-4 years after an ankle sprain up to 46% of people still had pain, 34% had recurrent sprains and 55% reported an unstable ankle.

It has also been reported that around 50% of all individuals who suffer from an ankle sprain do not seek attention from a health professional

Is there a correlation between these 2 facts? Or is there really nothing that can be done about an ankle sprain?

Here are some key “Do’s and Don’ts” for management of the early stages of an ankle sprain

Do

Get an initial assessment

When you roll an ankle, there can be a number of different structures involved. These may include on of or a combination of:

• ligament injury

• fracture

• tendon injury

• cartilage injury

• bone bruising

It can be difficult to decide who to see first. The Ottawa Ankle Rules are a reliable way to assess the need for an X-Ray. A very severe level of pain and an inability to weight bear may be an indicator that an X-ray may be needed. Your G.P or Emergency department may help you with this. As a physiotherapist, we can apply these assessment tools and clinical experience to tell you exactly what you need to do.

Move

Provided there is no fracture, the evidence tells us that early mobilisation of ankle sprains lead to better long -term outcomes. It is rare that we will need to use a Moon Boot or restrictive braces. Early mobilisation can actually reduce sensitivity and pain as well as getting you on the road to recovery.

Regain full function

Most ankle injuries will heal well and most pain will settle in time. BUT When people roll their ankle, they will often move in a way that is protective for a number of weeks until their pain has settled. In this time though, they have often lost a lot of movement, strength and proprioception (control of your joint). People will often return to normal activity using pain as a guide rather than function. This is one of the reasons recurrent ankle sprains and pain are so common.

Use Bracing/Taping

Many ankle injuries may require ongoing use of taping or bracing to reduce the chance of recurrence. Taping or bracing, if used as part of a good treatment plan, should not make your ankle “lazy” but rather increase the muscle around the ankles ability to react to rolling or landing awkwardly.

Don’t

Ignore it

As mentioned earlier, ankle sprains are notorious for causing long standing problems. It is crucial to get a correct diagnosis and management. A physiotherapist is a good place to start. Treatment may be as simple as providing advice regarding return to sport or in more severe cases involve a more in depth rehabilitation. It is also important to identify the need for any imaging such as an X-ray or MRI.

Immobilise for too long

Provided there is no fracture or any other reason as given by your healthcare provider, it is important to move earlier. Any swelling, stiffness and muscle inhibition can be alleviated with the guidance of your physiotherapist. Many ankles that are immobilised in Moon Boots are held still for too long become extremely stiff and can be often difficult to regain full range of movement. The key is knowing the right level of exercise!

Stop doing your exercises

Strength and proprioceptive (balance and control) exercise has been shown to be very effective in reducing recurrence of ankle sprains. The problem is, it needs to be ongoing. This may be as simple as 5 minutes worth or ankle exercise, 1-2 times per week to maintain strength.