What is a sprain?
This is a condition that occurs when the ligaments that support the ankle joint are stretched beyond their limit, in most cases this will involve an inversion movement of the ankle (the foot bends inwards).
What are the degrees of severity of a sprain
There are three types of ankle sprains:
1er degrees: this is a mild overstretch of the ankle ligaments (between 0 to 25% of the ligament fibers are affected).
2nd degree: this is a mild to moderate overstretching of the ankle ligaments (between 25 to 50% of the ligament fibers are affected).
3rd degree: this is a moderate to severe overstretching of the ankle ligaments (between a 50-100% of the ligament fibers are affected).
It can be a minor injury (1st degree) that will heal in a few days with just a little rest and ice or it can be a more serious injury (2 to 3 degrees) that will result in a significant tear in the ligaments that will take longer to heel.
What are the symptoms:
Symptoms vary depending on the severity of the injury. Typically, there will be pain in the lateral (outer) part of the ankle, swelling, difficulty supporting weight on the foot resulting in lameness and, in more severe cases, bruising/ecchymosis around the ankle and foot.
What can we do about it:
During the Acute Phase
This is the 1st week after your injury, in this phase, there is acute inflammation. Most movements will be painful. This is an unfortunate but important phase – our incredible body begins to repair the damage and build new tissue.
For this phase our objective is to protect the injured area: The treatment consists of applying the PRICE protocol (protection, rest, ice, compression and elevation)
PROTECTION: Use an ankle brace and in severe cases crutches or a walking boot.
REST: avoid walking, use a cane or crutches
ICE: apply ice to the area for 15 minutes every two hours.
COMPRESSION: Apply a compression bandage or ankle brace
ELEVEATION: elevation of the foot.
From the 2nd day, we can add a gentle movement of the foot (pumping action – the foot goes up and down) and we can start walking around the house for short distances.
During the Subacute Phase:
This phase lasts about 5 weeks, at this point our goal in physical therapy is to make the new tissue progressively stronger. We can achieve this through progressive range of motion exercises, strength training, advanced balance and proprioception exercises and functional rehabilitation – return to normal activities.
In general, your physical therapy treatments will include:
swelling and pain management
Prescription of progressive exercises Balance and proprioception training Education regarding the appropriateness of the orthosis and/or bandage
Depending on the severity of your ankle sprain, your physiotherapist will be able to move you through different stages of recovery and tell you when to return to your usual activities and sports. An active approach to your recovery will likely ensure the best results.
Although ankle sprains are common, proper rehabilitation has been shown to reduce the risk of future problems.
When to seek professional help:
If your symptoms do not significantly improve after 4-6 days of the sprain, if you cannot put weight on your foot, or if you generally feel that your healing is not progressing sufficiently, you should see your physiotherapist.