Ankle Sprain Overview

Ankle strain/sprain is when the tendon or ligaments surrounding the ankle has been stretched, or torn. Ankle strain/sprain is one of the most common sports injuries, and quite frankly a daily injury. Although it is very painful, it usually does not cause long term complications, if treated properly. Left untreated, muscles controlling the foot may become weak, unstable, inflexible, and is at increase risk for future ankle sprains. Chiropractic care can minimize this complication with adjustments, graston, physiotherapy, and/or kinesiology tape.

When to see your chiropractor or medical doctor:

• If you are unable to stand and put weight on it
• If you have intense pain above the ankle joint in the lower leg
• If there is no decrease in pain and swelling after a few days despite treatment (see below)

IMMEDIATELY AFTER AN ANKLE SPRAIN (24-72 HOURS)

You may notice swelling and possibly bruising. Minimize the swelling and bruising by following R.I.C.E.:

1. REST: This means not pushing the ankle to do too much, although some movement will help to get the swelling down. Try toe wiggling or gently moving the ankle up & down 10 – 15 times each hour. If you can stand on it without too much pain, then go ahead and walk as normally as possible. If not, you can use some crutches for a day or two.
2. ICE: Ice the ankle frequently to decrease pain & swelling. Ice for 10-15 minutes or until numb with an hour gap between icing periods.
3. COMPRESSION: Using a compressive bandage (like an Ace © bandage) can help support the ankle and reduce swelling; it should be wrapped from the middle of the foot to just above the ankle. Do not wrap too tightly!
4. ELEVATION: Keeping the ankle above your heart level will also help keep swelling down. (Perform ABC exercise, see below)

Over the next few weeks, the ankle will be busy healing. During the times when your foot is inactive (at work, or laying down at home), periodically move it to prevent the foot from becoming more stiff. Spelling the letters “A – B – C” with the foot forwards and backward, while staying pain free, is a great exercise. If there is no improvement in your ankle within the first week, see your chiropractor.
 

WHAT IS THE NEXT STEP?

When pain has subsided, and you are able to walk on the sprained ankle without favoring the ankle, begin to perform balance exercises. Rehabilitation  of the ankle decreases the risk of future ankle sprains. If you repeatedly tell yourself “I have a bad ankle”, you should read this as well. An article by the New York Times summarizes this efficiently in the link below:

http://well.blogs.nytimes.com/2009/07/08/how-to-fix-bad-ankles/?pagewanted=print

“Why should balance training prevent ankle sprains? The reasons are both obvious and quite subtle. Until recently, clinicians thought that ankle sprains were primarily a matter of overstretched, traumatized ligaments. Tape or brace the joint, relieve pressure on the sore tissue, and a person should heal fully, they thought. But that approach ignored the role of the central nervous system, which is intimately tied in to every joint. “There are neural receptors in ligaments,” says Jay Hertel, an associate professor of kinesiology at the University of Virginia and an expert on the ankle. When you damage the ligament, “you damage the neuro-receptors as well. Your brain no longer receives reliable signals” from the ankle about how your ankle and foot are positioned in relation to the ground. Your proprioception — your sense of your body’s position in space — is impaired. You’re less stable and more prone to falling over and re-injuring yourself. Researchers believe balance training can return the joint and its neuro-receptor function almost to normal.”

Excellent video produced by Jay Hertel from University of Virginia of balances exercises you can perform at home can be found in the link below:

www.nytimes.com/video/2009/07/08/magazine/1194841399365/ankles-a-balancing-act.html?scp=1&sq=Ankles:%20A%20Balancing%20&st=cse

Article for balance exercise produced by Craig Liebenson can be found in the link below:

http://www.craigliebenson.com/wp-content/uploads/2012/03/Balance-01.pdf 

SHOULD I WEAR AN ANKLE BRACE?

Ankle brace is especially useful during high levels of sport play for extra support during competition and practice. But excessive use of a brace can affect us in a negative way by teaching our muscles bad habits, becoming dependent on the brace. It is better to perform balance exercises, and strengthen the muscles surrounding the ankle for daily use and play.