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Acute Ankle Sprain Treatment

Published: 01 January 2013 - Clinical Conditions

What is an ankle sprain?

An ankle sprain is when one of the ligaments of the ankle joint is overloaded, resulting in a tear. The ankle joint is made up of four bones: the talus, calcaneus, tibia and fibula. These are held in place by a number of different ligaments – bands of strong connective tissue between two bones. 

These ligaments act together to prevent the foot and ankle from turning too far inwards or outwards. When this movement is forced past the limit that the ligament can withstand, tearing can occur.

Causes of ankle injury

Ankle sprains usually occur during activities that require sudden changes in direction, especially on uneven surfaces. 

Ligament injuries, called sprains, can range from a partial tear to a full rupture of the ligament and fracture of the bone. Most commonly ankles will roll inwards causing injury to the anterior talo fibula ligament (ATFL) or the calcaneo-fibula ligament (CFL) which are located on the outside borders of the ankle joint. 

Less commonly, the foot can also roll out, causing a tear to the inner (deltoid) ligaments.

Ankle sprain symptoms

A traumatic event can lead to a ligament sprain and is usually followed by pain and tenderness on the inside/outside part of the ankle. Swelling and bruising can also occur, and stiffness in the ankle can develop over subsequent days. 

An acutely injured ankle ligament will be made worse by walking and running, with pain often shooting into the foot and shin. Pain may also prevent weight bearing so that crutches may be required to assist walking. 

A thorough physiotherapy examination is normally enough to diagnose a sprained ankle, however x-rays may be required to rule out any fractures.

Ankle sprain treatment

  • The majority of ankle sprains respond well with appropriate physiotherapy management.
  • Firstly the ankle needs be rested in an elevated position. Ice should be applied for 20 minutes every 2-4 hours to aid in reducing swelling. A firm compression bandage should then be applied to the entire ankle, foot and lower leg. Heat, alcohol and further activity should be avoided to prevent any further damage or swelling to the ankle. This stage of the injury normally lasts for about 3 days and is called the inflammatory stage.
  • In the second stage of recovery, the pain, heat and redness begin to settle and the ligament starts to heal. During this stage, soft tissue massage and joint mobilisation techniques are used to optimally remould the healing scar tissue, help alleviate pain and prevent changes in ankle joint mobility
  • Commencing a graded exercise program is essential in preventing loss of ankle joint range and strength and helping to prevent further recurrent injuries
  • Ultrasound may be used in low dosages to promote more rapid and effective tissue healing
  • Sports tape can also be used to improve the stability of the ankle joint
  • Minor sprains can take 2-6 weeks to fully recover and return to normal activity. More severe sprains or ligament ruptures will require a longer period of rehab to gain full strength and function

How you can treat your ankle injury at home

  • A supportive brace  tted will help to immobilise the ankle joint, preventing further force being applied to the damaged ligaments. Once fully recovered, ankle braces are often used during activities to prevent subsequent sprains and injury
  • A structured exercise program is recommended, long after the injury has recovered. Usually this includes exercises to improve balance, strength, and movement
  • Ankle sprains are better when treated early to avoid the risk of becoming a “repeat re-sprainer”.If you have this problem, seek professional physiotherapy treatment immediately rather than letting it linger and hoping it will “just  x itself”

Click here to download the PDF factsheet