A sprained ankle is characterised by an over-stretching, and sometimes tearing, of the strong ligaments that support the ankle. This more commonly happens on the outside of the ankle, but can also happen on the inside. A ligament is strong fibrous tissue that connects a bone to another bone so they are crucial for stability in your joints. Ankle sprains are very common but can be very disruptive to your lifestyle, especially if you aren’t able to walk without pain.
Ankle sprains are usually caused when the ankle unexpectedly twists causing damage to the ligament(s). After an ankle sprain, you can expect pain in the affected area, swelling and also bruising. It’s also likely your movement will be more restricted than usual and you may have difficulty putting your full weight on that foot.
Typically we classify an ankle sprain into three categories, depending on the severity of the injury:
This is what we’d classify as a mild sprain, where there has been slight stretching or microscopic tearing of the ligament fibres. Common causes of a mild sprain are inversion movements, such as a sudden twisting of the foot, which are very common in sports like football. You can expect a bit of swelling and slight bruising, but you’ll generally be able to walk on it. Applying some ice and trying to rest should mean you’ll see improvement in a week or two.
This type of sprain is a significant injury and there may be a partial tear of a ligament. This means you may find it difficult to put full weight on that foot and there could also be quite a bit of pain when you do so. You may also experience some bruising which could go right down to the toes.
This type of sprain is the most severe category and would usually indicate a full rupture of a ligament. This can create instability in the ankle, so the symptoms described above will be far more significant and intrusive. If you’re in severe pain you should see a doctor or your local A&E department to check the ankle isn’t fractured, as tests and scans may be required in the assessment.
Having a physiotherapy assessment means a full, subjective background of the injury can be discussed to review the sprain itself and particular twisting movements which may have contributed to the injury. This is also a great chance to discuss your recovery goals e.g. if there’s a particular event you’d like to compete in, as this may affect the physiotherapy programme and the types of exercises that are recommended.
Your physiotherapist will also complete an objective assessment, which involves observing any bruising, swelling and discolouration on the ankle. They will check movement in all directions of the foot, along with signs for loss of strength and power in particular muscles. The goal is to fully assess walking and functional movement, checking the ligaments for signs of tearing and also rule out any nerve damage. We may also recommend that you have an X-ray or refer you to a foot and ankle specialist.
If you’re experiencing mild discomfort from a suspected sprain, then there are several things you can do to help. The “PRICE” method is a great place to start in the 48 hours following a mild injury:
Once your symptoms are improving then a gradual return to weight-bearing exercises, such as walking with support, is the next step. A good exercise to do is “heel raises” which is simply going up and down on your tip toes. Squats and balance exercises are also good as these help to improve the stability of the ankle after the ligament has been sprained.
However if you’re not showing signs of improvement after 48 hours, then seeing a physiotherapist for an assessment will allow you to get a personalised treatment plan to get your recovery under way.
If you’ve decided to see a physiotherapist, they will personalise a treatment plan based on your specific injury and your recovery goals. They will recommend and demonstrate targeted exercises to help and can also provide taping on the ankle to offer support if needed. They’re also trained to provide hands-on treatment, such as soft tissue massage and manipulation, as this can help to stimulate healing of the injury.
At Circle Rehabilitation, we also have state-of-the-art equipment on-site to help with your recovery. The AlterG anti-gravity treadmill is a great way to exercise the joints as it effectively reduces your bodyweight on the treadmill by using a vacuum, which in turns reduces the pressure on the knees and ankles.
The Biodex Balance SD is also designed to help with balance and stability, which may have been affected by the ligament injury.
Recovery time will vary for each patient, but typical recovery times for ankle sprains are listed below:
- Grade 1 – two to four weeks
- Grade 2 – four weeks to three months
- Grade 3 – up to 6 months for a severe sprain.
Your physiotherapist will also see you for regular follow-up appointments to check your progress and adjust your treatment plan if necessary. Typically follow-up appointments are every one or two weeks, but can be several times a week for severe sprains in the early stages. The team will also provide printed instructions for exercises you can do at home which serve as a visual guide to achieve the correct technique.