At Endeavour, we see a ton of ankle sprains, and while it is especially common among athletes, it is also a common injury for the general population. Early intervention is critical with this injury. Just as important, though, is seeing the treatment through to full recovery to ensure this injury doesn’t wreak havoc on the rest of your body later in life.
An ankle sprain is an injury where the ankle is rolled or twisted, taking the joint beyond its normal range of motion, which causes straining or, in severe cases, tearing of different ligaments and muscles around the ankle. The majority of ankle sprains involve the ankle rolling outwards with the damage occurring to the outside tissues, but in some cases the ankle can also be sprained inwards.
In a typical ankle sprain where tissue damage occurs, usually there is immediate pain in the ankle, with swelling and sometime bruising appearing within a short time. It is often painful to walk and move the ankle in different directions. In severe cases, there may also be a fracture or bone break. To rule out the potential for fracture, and to get the inflammatory response under control, an early visit to a physiotherapist is crucial.
When you sprain your ankle (or get any injury for that matter) the body’s nervous system coordinates all sorts of resources to respond to the injury. The body naturally responds by sending different chemicals and fluid to the damaged area. The presence of these substances is what causes the swelling, sensitivity and pain after the sprain as the nerves in the ankle become hyper-sensitized by the chemistry change in the area.
Early treatment in the form of electro-acupuncture, ice, and gentle movement helps prevent this process from getting out of control. In particular, electro-acupuncture is helpful in calming down the body’s nervous system to prevent it from over-sensitizing the nerves and tissues of the ankle joint, which will help with pain control. But more importantly, calming down the nervous system helps to get the inflammatory process under control, which makes for a much quicker recovery. With the inflammatory process under control, there is less swelling and sensitivity in the joint which allows for a faster restoration of full and pain-free movement, strength and overall function. A delay in waiting for treatment allows the inflammatory process to rage on unchecked which will create a mess in the joint that will take lots of time and treatment to clean up.
Thorough treatment of ankle sprains involves goals that are specific to the stage of injury, the current trouble a patient has, and their overall goals. Early on, the goal is to restore normal nervous system activity and work on fully removing any inflammatory by-products and swelling that can linger in the joint after the injury. This involves techniques like electro-acupuncture, manual therapy, gentle movement/exercises, stretching, ice and once tolerated, cupping.
As time goes on, restoring full mobility and strength in the joint becomes the number one goal. Your therapist may use more targeted acupuncture techniques to target muscles that remain weak along with advanced manual therapy techniques and progression of exercises to work on mobility and strength.
Finally, your therapist should be sure you are able to do every movement your body requires pain-free and without compensation to make sure the joint can protect itself from future ankle sprains. This will involve exercises to address balance and proprioception (the body’s ability to sense where the joint is in space) and sport-specific exercises.
A good therapist also ensures that muscles throughout the kinetic chain in your leg are all working well and working together so that there are no weak links in the chain that might put you at risk of future injury.
Often when a person sustains an ankle sprain, the need for treatment is obvious, but for many people who have never experienced an injury before, the first thought isn’t necessarily to have it treated. Instead, they rest, which, while somewhat necessary, can create an environment in the ankle that delays recovery. Plus, many patients will stop treatment once the pain is mostly resolved and they are back to most activities.
Once again, fully treating this injury to achieve full mobility, strength, balance and proprioception will ensure the risk of future injuries caused by this old ankle sprain, are greatly minimized. Getting your ankle sprains treated early and completely is the only way to ensure that you can prevent this injury from keeping you out of the things you love.