Most of us, at some point, have suffered an ankle sprain. It doesn’t take much to “roll” an ankle – jumping for a rebound and landing awkwardly, a misplaced step while trail-running, even a simple slip or trip.
Most of the time the injury is relatively minor and will recover well with rest, elevation, ice and anti-inflammatories. But sometimes a sprained ankle can be more complex and require more specialised attention.
What actually happens to my ankle when I sprain it?
To manage a sprained ankle correctly, and recover fully, it helps to understand the anatomy of the ankle joint and what happens when it’s sprained or twisted.
The ankle is a hinge joint, formed by the bones of the lower leg (tibia and fibula) and the talus, one of the many bones in the foot. Strong, fibrous ligaments run across either side of the joint to connect the bones together and help stabilize it. Most sprains affect the outside (lateral) of the ankle when it’s forced into inversion (rolled) and ligaments are stretched beyond their limits.
Sprains can range from mild (grade 1) where tiny tears in the ligaments occur, to severe (grade 3) where the ligaments are completely torn.
Without proper rehab more severe sprains can weaken the ankle joint, cause recurrent injuries, instability, and in the long term, arthritis and chronic pain.
Ankle sprains are common in sports like netball, football, basketball and trail running (which all require a lot of foot twisting and planting), and when exercising on uneven surfaces.
Also important are the microscopic proprioceptors that sit within the ankle joint and the surrounding tendons/ligaments. These provide constant feedback to our brains about where our foot is in space and what adjustments we need to make to keep us stable and safe. Proprioceptors are often damaged by the trauma of an ankle sprain and their ability to function can be impaired. The result? Risk of recurrent injury.
How do I avoid an ankle sprain and complications from it?
The first step is prevention.
Warm up thoroughly, pay attention to the surface you’re running or playing on, and wear shoes suited to the activity you’re undertaking. If you’ve had previous ankle injuries consider having the ankle taped or braced for extra support while playing sport – discuss this with your physiotherapist.
How do I manage an ankle sprain?
If you do suffer an ankle sprain, most people return to sport and full function, providing the right treatment is undertaken.
This involves initially resting, icing and elevating the ankle. Compression dressings are useful at this stage to help minimise swelling and immobilize the area to protect it.
After the acute phase, treatment should be focused on restoring range of motion, strength and flexibility.
Retraining proprioception and dynamic strength are an important part of rehab to help restore the joint’s proper function and decrease risk of recurrent injuries.
Gradual return to activity, with maintenance exercises, should be gently introduced, initially avoiding a lot of twisting and turning that will stress the injured area.
A physiotherapist can help guide you through all of the above.
For a minor sprain, recovery may take as little as two weeks, but for the more severe, it can be anything from six – 12 weeks.
If, after a few days it is still very swollen, you’re unable to weight bear and it’s difficult to keep the pain under control, see your doctor to rule out a fracture.