We hear it all the time. “I sprained my ankle.” Sometimes it’s while playing tennis, other times stepping off a curb awkwardly can be the culprit. But as injuries go, this one seems to be oh so common. But when a friend utters those infamous words… I rolled my ankle, how do they know?
In fact, right away, they really don’t. Not until they’ve been assessed. After all, when an ankle really is sprained, ligaments on the ankle are either stretched, partially torn or completely torn. The most common type of ankle sprain is where the foot is rotated inward. And ankle sprains can range from mild, to moderate, to severe.
The number of ways to sprain an ankle are nearly as numerous as there are ankles. Or at least it seems that way. But generally a sprain can happen in the following ways:
- Awkwardly planting the foot when running, stepping up or down, or during simple tasks such as getting out of bed.
- Stepping on a surface that is irregular or unstable, such as stepping in a hole
- Athletic events when one player steps on another player (A common example is a basketball player who goes up for a rebound and comes down on top of another player’s foot. This can cause the rebounder’s foot to roll inward.)
When you do sprain an ankle, it always begs the question, now what? Well the best place to start is to confirm the injury. So, see your Doctor. As for rehabilitating the ankle, this is where an Athletic Therapist can really help.
Rehabilitation or treatment is used to help to decrease pain and swelling and to prevent long term ankle problems. Ultrasound and electrical stimulation may also be used as needed to help with pain and swelling. At first, rehabilitation exercises may involve range of motion or controlled movements of the ankle joint without resistance. Water exercises may be used if land-based strengthening exercises, such as toe-raising, are too painful.
Lower body exercises and endurance activities are added as tolerated. Balance training – such as standing on one foot or using a wobble board– is very important. Poor balance, or the inability to know where our limbs are in space without having to look, is a major cause of repeat sprain and an unstable ankle joint. Once you are pain-free, other exercises may be added, such as movements that require quick change in direction. The goal is to increase strength and range of motion as balance improves over time.
When you sprain an ankle, you can expect your recovery to go through three phrases:
- Phase 1 includes resting, protecting the ankle and reducing the swelling (one week).
- Phase 2 includes restoring range of motion, strength and flexibility (one week to three weeks).
- Phase 3 includes gradually returning to activities that do not require turning or twisting the ankle and doing maintenance exercises. This will be followed later by being able to do activities that require sharp, sudden turns such as tennis, basketball or football.
If you have sprained your ankle in the past, you may continue to sprain it if the ligaments did not have time to completely heal. If the sprain happens frequently and pain continues for more than four weeks to six weeks, you may have a chronic ankle sprain. Activities that tend to make an already sprained ankle worse include stepping on uneven surfaces, cutting or twisting actions and sports that require rolling or twisting of the foot, such as trail running, basketball, tennis, football and soccer.
Of course, there are things you can do to help you prevent an ankle sprain:
- Warm-up before doing exercises and vigorous activities
- Pay attention to walking, running or working surfaces
- Wear shoes with good support
- Pay attention to your body's warning signs to slow down when you feel pain or fatigue
At the end of the day, as any Athletic Therapist will tell you, maintaining good strength, muscle balance and flexibility can be a real plus to keeping that ankle from becoming your Achilles heel.
R.Kin, RMT,CAT(C), SMT(C)
As a former competitive swimmer, Jason White experienced his share of injuries and treatment. His desire to help others overcome injuries and resume healthy lifestyles led him to becoming an Athletic Therapist and RMT, and is the focus of his current private practice.