What is an ankle sprain?
A sprained ankle occurs when you twist your ankle and the ligaments get overstretched. They vary in severity, from a mild sprain with little swelling to a tear of the ligaments and the possibility of a fracture.
How does it happen?
Ankle sprains can occur simply by rolling your ankle on uneven ground or stopping suddenly and landing awkwardly.
What are the symptoms:
– A pop or crack may be heard
– Swelling and bruising
– Pain over the ligament that is damaged
– Difficulty weight bearing – you may need crutches for a few days or a boot
Pain above the ankle or an inability to weight bear may indicate additional damage and should be reviewed by a physio or doctor.
Treatment: How can I speed up my recovery?
For the first 72 hours, it is known as an acute injury, and therefore the POLICE principle should be applied.
POLICE, not RICE or PRICE – protect, optimal load, ice, compression, elevation
- PROTECT – with taping or bracing but total rest is not needed after the initial period as muscles become weaker with total rest
- OPTIMAL LOADING – Weight bearing with minimal pain
- ICE – 10 mins
- COMPRESSION – the tape and brace can help with this
- ELEVATION – keep it up to allow swelling to drain – anti-inflammatories such as ibuprofen are no longer recommended as they can limit the potential of the body to bring about full healing.
Once the swelling is down and you can move the ankle in a pain free motion, management includes progressive strengthening and balance retraining. In the meantime, keep fit with cross-training such as cycling and swimming.
What should I do now to get back to running and prevent this from happening?
Restoring good balance and strength is key to both restoring function and preventing recurrence. Try these at exercises at home:
1. Stand on one leg without losing your balance. Progress to closing your eyes, standing on a cushion or wobble board and playing catch against the wall.
2. Once you have good balance, add some skipping, then hopping. Make sure you can balance on tip toes and walk across a room on tip toes. Until you can hop pain-free you should not contemplate running.
3. When you introduce running, avoid back-to-back days and use short intervals before adding distance. Don’t add change of direction or twisting in the early stages.
4. Resistance band exercises can be effective too to build up the muscles (the evertors) that stop the foot from turning in (see video below).
5. Taping the ankle or wearing a brace will not make the ankle weaker so you should consider this for several months after a sprain to allow the area to fully heal again.
Recurrent ankle sprains can occur in 40-70% of people and it is therefore important to make sure you fully rehab the first event with good physiotherapy input. If you call the said ankle “weak” the brain listens and over time you tend to protect it and make it become even weaker, so make sure you refer to it as the right or left one from day one.
Whilst some injuries are just bad luck, there are certain things you can do proactively to prevent them. Try the balance exercise and resisted band exercises listed above. Do lots of strength drills for the hip and gluts on one leg to build stability and balance on single leg stance.