Acute Ankle Sprain: What does it mean and Where to from here?

What does ‘ankle sprain’ mean?

A sprain is a term used to describe a ligament injury, where the ligament has been over-stretched or sometimes torn. They typically occur due to joint trauma, or a joint being taken past its range of motion. An ankle sprain is therefore, an injury to the ligaments connecting the bones of the ankle joint.

What are normal symptoms?

  • Tender to touch
  • Sudden and intense pain
  • Swelling and bruising
  • Joint stiffness
  • Walk with a limp

What ligaments have I sprained?

The ligaments injured, depend on how you have sprained your ankle

Rolling your ankle inwards

Rolling your ankle outwards

How long until I get better?

Sprains are graded from 1 to 3 based on their severity, with 1 being the lowest and 3 the highest.

Grade 1 indicates mild stretching and damage, with 1-2 weeks for recovery

Grade 2 indicates partial tearing, with 4-6 weeks for recovery

Grade 3 indicates complete tearing, with 3 or months for recovery

Is this a serious condition?

Although painful, this is not a condition you should worry about, as ankle sprains make up 40% of all sporting injuries. However, if you have the symptoms depicted above you should go to the hospital for X-rays.

Management

  • Initial Phase (Limit inflammation and bleeding)
    Rest, with the ankle elevated and compressed
  • Crutches, for the first 24 hours to allow for weight-bearing, without being excessive
  • Gradual weight-bearing, to promote ankle motion

Intermediate Phase (Restore pain free motion)

  • Begins when you no longer experience pain at rest
    Involves moving your ankle actively in all pain free directions
  •  Strengthening exercises can begin slowly
  • An ankle brace can be used to help manage pain with work, however, it is important to not become dependent on it

Advanced Phase (Restore function)

  •  Begins when pain free and swelling is no longer present
  •  Involves advanced exercises that aim to strengthen and reduce the chance of re-injury
  • They should be advised by and done in the company of a trained professional

Avoid

  • Alcohol
  • Cigarettes
  • Stress
  • Overwork
  • Complete rest

Reduce Stress

  • When injured, the body produces stress hormones
  • This places strain on the body, prolonging the healing period
  • This response can be reduced through treatment focusing on the nervous system

Restore Ankle Motion

  • Mobilization techniques directed to the foot and ankle joints will promote movement
  • With this, it may also promote a faster healing time

What if I do nothing?

Doing nothing may result in a longer recovery time.  The tissues may not reach the strength they would have otherwise. The ankle joint may become chronically unstable, which can increase the likelihood of:

  • Re-injuring the ankle
  • Developing osteoarthritis

Osteopathic Treatment

Reduce Pain and Swelling

  • Pain and swelling cause discomfort and limited motion
  • If drawn-out, this can result in a longer than usual healing time and increased risk of re-injury
  • Massage and mobilization can be used to minimize these effects

Written by James Goetz for acesportsclinic.com

 

Reference:

1. Adelaide Crows Sports Medicine Clinic [Internet]. 2017 [cited 2 September 2017]. Available from: http://www.adelaidecrowssportsmedicineclinic.com.au/ankle-sprain/

2. Dubin JC, Comeau D, McClelland RI, Dubin RA, Ferrel E. Lateral and syndesmotic ankle sprain injuries: a narrative literature review. Journal of chiropractic medicine. 2011 Sep 30;10(3):204-19. doi.org/10.1016/j.jcm.2011.02.001

3. Ankle Sprains” When should you be concerned? [Internet]. 2017 [cited 2 September 2017]. Available from: http://www.sportdoclondon.co.uk/ankle-sprains-when-should-you-be-concerned/

4. Inversion Ankle Sprains [Internet]. 2017 [cited 31 August 2017]. Available from: https://gymnasticsinjuries.wordpress.com/2012/10/11/inversion-ankle-sprains/

5. Medial ankle sprain [Internet]. 2017 [cited 2 September 2017]. Available from: https://www.slideshare.net/AwiniMohamed/medial-ankle-sprain-53753126

6. Different Grades Ankle Sprain [Internet]. 2017 [cited 2 September 2017]. Available from: http://iwalk-free.com/injury-resource-center/sprained-ankle/

7. Chan KW, Ding BC, Mroczek KJ. Acute and chronic lateral ankle instability in the athlete. Bulletin of the NYU hospital for joint diseases. 2011 Jan 1;69(1):17.doi: http://www.presentationgrafix.com/_dev/cake/files/archive/pdfs/238.pdf

8. Tiemstra JD. Update on acute ankle sprains. Am Fam Physician. 2012 Jun 15;85(12):1170-6. Available from http://familymed.uthscsa.edu/residency08/MMC/Ankle.pdf

9. Ottawa Ankle Rules [Internet]. 2017 [cited 2 September 2017]. Available from: http://www.bmj.com/content/326/7386/417

10. When It Comes To Physical Therapy, Patients Have To Do The Work [Internet]. 2017 [cited 2 September 2017]. Available from: http://www.chelseafootandankle.com/blog/when-it-comes-to-physical-therapy-patients-have-to-do-the-work

11. Kemler E, van de Port I, Backx F, van Dijk CN. A systematic review on the treatment of acute ankle sprain. Sports medicine. 2011 Mar 1;41(3):185-97. doi.org/10.2165/11584370-000000000-00000

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