Ankle sprains are among the most common injuries in both sports and everyday life. They can affect anyone, from elite athletes to individuals simply walking on uneven surfaces. These injuries often occur when the ankle twists or rolls in an unnatural way, stretching or tearing ligaments that stabilize the joint. With a clear understanding of the different types of ankle sprains and an evidence-based approach to treatment, our physiotherapists can help patients in Booragoon regain mobility and prevent future injuries.
Types of Ankle Sprains
1. Lateral Ankle Sprains
Lateral ankle sprains, or “inversion sprains,” are the most common type of ankle injury. They occur when the ankle rolls inward, overstretching or tearing the lateral ligaments—particularly the anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL). These sprains typically happen during activities that involve sudden direction changes or unstable surfaces.
2. Medial Ankle Sprains
Less common than lateral sprains, medial ankle sprains involve the deltoid ligament complex on the inside of the ankle. This type of injury occurs when the ankle rolls outward (eversion) and often results from a high-impact force or fall. Medial sprains may also accompany fractures due to the strength of the deltoid ligament, making them particularly serious.
3. Syndesmosis Sprains (High Ankle Sprains)
Syndesmosis sprains, or “high ankle sprains,” involve the ligaments connecting the tibia and fibula above the ankle joint. These injuries occur when the foot is planted, and the leg twists outward, forcing the tibia and fibula apart. High ankle sprains are common in contact sports, such as rugby and football, and often require a longer recovery period than lateral or medial sprains due to their complex nature.
Evidence-Based Treatments for Ankle Sprains
While the pain and limited mobility from an ankle sprain can be frustrating, physiotherapy offers effective treatments based on the latest research. By addressing pain and inflammation early on and incorporating targeted rehabilitation techniques, physiotherapists can guide patients back to full functionality and reduce the risk of reinjury.
Traditional/Evidence-Based Approach
The traditional approach to treating ankle sprains, often remembered by the acronym RICE (Rest, Ice, Compression, Elevation), is still relevant but has evolved. Current evidence supports a modified approach that includes early movement within pain limits to promote circulation and tissue healing. The goal is to minimize swelling, reduce pain, and prevent further injury.
- Rest: While rest is important, prolonged immobilization can lead to stiffness and delay recovery. Physiotherapists encourage controlled movement as soon as possible.
- Ice: Applying ice to the injured area reduces pain and inflammation, particularly within the first 48 hours. Evidence supports intermittent icing for 10-15 minutes every few hours.
- Compression and Elevation: Wrapping the ankle with a compression bandage and elevating it above heart level helps reduce swelling. These techniques should be maintained until swelling subsides.
Incorporating early functional movements, such as gentle ankle circles and toe exercises, is now commonly recommended to prevent muscle wasting and joint stiffness.
Manual Therapy
Manual therapy is a valuable component of ankle sprain treatment. Research shows that joint mobilizations, soft tissue massage, and manipulations can significantly reduce pain and improve range of motion in the affected ankle. For example:
- Joint Mobilizations: Physiotherapists often perform gentle joint mobilizations to help restore normal movement in the ankle joint. Mobilizations help to realign the joint, improve proprioception, and reduce stiffness.
- Soft Tissue Techniques: Techniques like massage and myofascial release can address any muscle tightness or fascial restrictions around the ankle. This not only reduces pain but also enhances mobility, making it easier to progress through rehabilitation exercises.
In combination, manual therapy techniques can speed up recovery by reducing muscle tension, improving circulation, and restoring joint function. It’s particularly beneficial for patients dealing with chronic ankle instability after multiple sprains.
Exercise Rehabilitation
Exercise rehabilitation is crucial in treating ankle sprains and building resilience to prevent future injury. A tailored exercise program helps restore strength, balance, and proprioception (the body’s ability to sense its position in space), which are essential for preventing reinjury.
- Range of Motion Exercises: Early exercises aim to regain full ankle mobility. These include gentle ankle circles, alphabet exercises (using the foot to “draw” letters), and dorsiflexion/plantarflexion movements.
- Strengthening Exercises: Strengthening the muscles surrounding the ankle joint helps stabilize the joint and protects the ligaments. Typical exercises include resisted ankle movements with a band, calf raises, and toe raises. These exercises target not only the ankle muscles but also the calves and peroneals, which contribute to ankle stability.
- Balance and Proprioception Training: Proprioception exercises help retrain the body’s balance system, which is often impaired after an ankle sprain. Single-leg balancing on stable and unstable surfaces, heel-to-toe walking, and agility drills improve stability and reduce the risk of recurrent injuries.
Gradually progressing through these exercises as the ankle heals ensures a safe return to daily activities or sports while minimizing the chance of reinjury.
Strengthening and Building Resilience for the Future
To achieve lasting recovery, physiotherapy aims not only to heal the immediate injury but also to build a resilient ankle. Strengthening and resilience exercises can fortify the ankle’s stability and adaptability, reducing the likelihood of future sprains.
- Functional Strength Training: Exercises like single-leg squats, lunges, and step-downs integrate the ankle with other joints, teaching it to function efficiently under load. These exercises simulate real-life movements and prepare the ankle for complex activities.
- Plyometric and Agility Drills: For athletes or those returning to high-demand activities, plyometric exercises (like jump training) and agility drills improve speed, power, and dynamic stability. Exercises such as lateral jumps, shuttle runs, and ladder drills replicate the quick movements that often lead to ankle sprains, providing a controlled environment to train safely.
- Injury Prevention Strategies: Physiotherapists educate patients on strategies to reduce the risk of reinjury, including proper warm-up routines, footwear selection, and avoiding unstable surfaces when possible.
Conclusion
Ankle sprains, whether lateral, medial, or syndesmotic, can vary widely in severity and required recovery time. By understanding the type of sprain and following an evidence-based treatment approach, physiotherapists can provide effective care that accelerates healing and builds long-term resilience. Through a combination of manual therapy, targeted exercise rehabilitation, and strength training, patients in Booragoon can not only recover from ankle sprains but also reduce the risk of future injuries.
If you’re dealing with an ankle sprain or want to prevent one, seeking the guidance of a qualified physiotherapist here at Adaptive Physiotherapy & Massage in Booragoon is a proactive step toward achieving optimal ankle health and mobility.
References
- Van Mechelen, W., et al. (2019). “Sports Injuries and Prevention: The Role of Physiotherapy.” British Journal of Sports Medicine.
- Hubbard-Turner, T., & Turner, M. J. (2015). “Physical Therapy Interventions for Ankle Sprains.” Journal of Orthopaedic & Sports Physical Therapy.
- Bleakley, C. M., et al. (2014). “The Use of Manual Therapy in the Treatment of Ankle Sprains: Evidence-Based Recommendations.” Physiotherapy Research International.
- Hupperets, M. D., et al. (2020). “Strengthening and Proprioception in the Prevention of Ankle Sprains.” Journal of Athletic Training.
- Feger, M. A., et al. (2021). “Progressive Rehabilitation Techniques for Ankle Instability.” International Journal of Sports Medicine.
Our Physiotherapists here at Adaptive Physiotehrapy & Massage are equipped with the latest knowledge to support effective recovery from ankle injuries, ensuring that each individual regains full function and confidence in their ankle stability.
