The most frequent kind of ankle injury is a sprain involving the ligaments and bones in the ankle. This might result from a sports injury but could also come from people running for a train, running down the stairs or catching their foot on a kerbstone, particularly when wearing high heels.
Ankle sprains are common in all ages though elderly people who have reduced balance and mobility may be particularly susceptible. Other common ankle injuries and conditions that could benefit from rehabilitation treatment include a torn muscle or overstressed tendon, ongoing ankle instability, plus ankle fractures once the bone has largely healed.
The first aim in rehabilitation of an injured ankle is to try and get the swelling down, which is done at Circle with a Game Ready cold compression pack, widely used in professional sports. A cuff is placed around the joint and pumped full of a mixture of water and ice; at the same time it provides pulsing compression to take fluid away. Then physiotherapists will manipulate the ankle to try and get movement into the joint.
Circle Rehabilitation has a suite of state-of-the-art machines for treatment and exercise, unique in the UK outside specialist facilities for armed forces members, police officers and sports professionals. To get those walking with a limp because of ankle injury into a normal walking pattern – referred to as a “reciprocal gait” – sessions on the AlterG anti-gravity treadmill may be beneficial. This creates a vacuum removing up to 80% of a user’s bodyweight, allowing them to exercise for longer and harder than they could unaided, and without risk of injury. As the swelling goes down, patients can use the Biodex balance system, which assesses ankle stability and balance on a dynamic footplate with gameified exercises.
If the patient is a sports enthusiast with an ankle injury, they can try biometrics to assess their movement, and muscle isokinetic testing on the sophisticated Biodex System 4 to evaluate their strength, as they return to sport and exercise. Our therapists can perform ankle taping to provide stability and pain relief and we can provide ankle orthotics and braces for support. We have gym equipment such as Bosu balls and AIREX cushions to help patients strengthen the muscles of the calf and foot.
With its holistic approach and multidisciplinary, experienced team, Circle Rehabilitation offers the advantage of ongoing rehabilitation with assessment, so that patients with ankle conditions can see the change in their condition over time. The range of equipment and opportunity for barrier-pushing exercises both enables a quicker recovery and makes for a stronger ankle in the long run.
Operations are performed to strengthen the ligaments which support the outside of the ankle in patients who sprain or turn their ankle regularly in spite of trying adequate physiotherapy.
The first phase of your recovery will be focused on managing your pain and reducing swelling. Your lower leg will be placed in a plaster and you will be provided with elbow crutches and be instructed to take no weight or partial weight through your operated leg for at least two weeks after surgery. Throughout this time, it is advisable to elevate your lower leg regularly to help reduce swelling. Under normal circumstances, after 2 weeks, the plaster will be removed, you will be able to take full weight on your operated ankle and your ankle will be placed in a softer ankle/foot brace to limit movement.
The second phase of your recovery will focus on enabling you to be able to walk with a more normal gait pattern, wean off your ankle brace as quickly as possible and strengthen your ankle and foot muscles. For this, your physiotherapist will prescribe exercises to target each of the ankle/ foot muscles with particular emphasis on strengthening your peroneal muscles and tendons. As your strength improves, your physiotherapist will advise you on some weight bearing strengthening and balance exercises to further improve the stability of your ankle and support your lateral ligament complex. Over this period, stretches of your ankle joint in to dorsiflexion (foot up position) will also be encouraged to prevent any longer-term stiffness developing which can limit function.
The third phase will begin once your walking pattern has normalized and you have enough strength and stability to begin more complex movements and impact work. You will typically start off with light impact work such as jogging on the treadmill and exercises such as squats, lunges and heel raises. Your physiotherapist will guide you but under normal circumstances once the strength of your operated leg is equal to your non-operated leg, activity or sports specific rehabilitation exercises can be commenced. This may include progressing to sprinting, jumping and rotational movements. Usually caution is given when progressing exercises after a lateral ankle stabilisation. A normal time frame for a full return to sport is up to nine months.