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So you have gone over on your ankle? You are not alone. A sprained ankle, or lateral ankle ligament sprain, is frequently experienced in both the general and sporting population with 40% of these occurring during sports (1, 2.) Despite this high prevalence, it is thought that only 50% seek medical attention (3.)
A large proportion will develop chronic long-term ankle instability with symptoms including recurrent pain, swelling and giving way. So make sure you get an accurate diagnosis and appropriate physiotherapy treatment to reduce the risk of complications and recurrence.
In the first 72 hours, follow the guidelines for ‘RICE:’
Thereafter early weight-bearing and instigating range-of-movement exercises are encouraged.
If you are unable to weight bear (difficulty standing or walking) due to pain. you need to keg an x-ray due to the risk of an ankle fracture (1,2.)
It is advisable to see a physiotherapist if there is significant bruising or swelling. This would typically indicate a more severe sprain. Another cause for self-referral to a physiotherapist is persistently high levels of pain 3 days post-injury.
A further referral to a sports doctor, orthopaedic consultant, x-ray, ultrasound scan or MRI, would be appropriate under a number of circumstances. These would include if, once we had carried out a detailed assessment of the ankle, we thought there was a chance of any of the following things;
Typically the time needed to return to normal activity depends upon the severity of the sprain and for this we use a grading system:
The average time to return to sport or full weight-bearing status is six weeks for a Grade I sprain, 6-12 weeks for a Grade II sprain, and up to three months for a Grade III sprain. A Grade III may be managed conservatively or surgically and is discussed should this event occur.
The goal of treatment and rehabilitation is to prevent chronic ankle instability. Ankle injuries with some degree of instability have a 35% chance of at least one re-sprain within the first three years (2.) The main predictive factor for risk of recurrence and chronic instability is the severity of the original injury (1,2,4.)
There is a whole section of foot and ankle exercises that we would recommend after you have had your ankle assessed by a physio. You can click here to see the full set or check out the links below for our top three:
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1. Hertel J, Anatomy F. Functional Anatomy, Pathomechanics, and Pathophysiology of Lateral Ankle Instability. J Athl Train2002;37:364–75
2. Lynch SA, Renström PA. Treatment of acute lateral ankle ligament rupture in the athlete. Conservative versus surgical treatment. Sports Med 1999;27:61–71.
3. Verhagen EA, van Mechelen W,de Vente W. The effect of preventive measures on the incidence of ankle sprains. Clin J Sport Med 2000;10:291–6
4. Delahunt E, Coughlan GF, Caulfield B, et al. Inclusion criteria when investigating insufficiencies in chronic ankle instability. Med Sci Sports Exerc 2010;42:2106–21
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