Have you ever wondered what some of the most common injuries are in all age populations? Well, ankle sprains are one of them! In fact, it is the number one reason why someone might miss out on participating in sports. Luckily, there are many ways to approach treatment for this injury without the need for surgery!

What is an Ankle Sprain?

The ankle joint is surrounded by bands of tissue called “ligaments,” and these structures help to stabilize and support the ankle. When the ankle is forcefully moved into a position beyond the normal range, these ligaments get stretched and torn. This can happen if you roll your ankle, walk/run on uneven surfaces, land awkwardly after a jump or turn, trip on an object, or fall. It can often happen in sports where athletes perform cutting movements and change of directions, or when a player steps on your foot during a game. The most common way to sprain your ankle is rolling the ankle outwards, while the foot turns inwards; this is referred to as an “inversion” ankle sprain. In this case, the ligaments on the outside of your ankle get stretched and/or torn.

There are 3 main ligaments on the outside of your foot: anterior talofibular ligament (ATFL), calcaneofibular ligament (CFL), and posterior talofibular ligament (PTFL). ATFL and CFL tend to be the ligaments that are torn most often. Alternatively, some people can sprain ligaments located on the inside of their ankle, but this is less common. This is called an “eversion” ankle sprain, where the ankle rolls inwards and the foot turns outwards, stretching and/or tearing the medial ligament called the “deltoid ligament.” There are certain sports that are at a higher risk of getting an ankle sprain. These include basketball, tennis, football, soccer, and trail running!

What are the Signs and Symptoms of a Sprained Ankle?

There are a few signs and symptoms that you might encounter after injuring your ankle. Depending on the severity of your sprain, you can experience pain at rest, when you put weight on the ankle, and/or during certain activities. Some swelling and bruising can be present, and it will often be tender or painful to touch. You may also feel like you can’t move it through a normal range. Some people report feeling like their ankle is giving out or being less stable than usual. If your symptoms are very severe, your healthcare professional might send you off to get an X-ray to rule out a fracture or other potential injuries to the structures nearby. However, diagnostic imaging is not always necessary to diagnose an ankle sprain!

How do I Know How Severe my Ankle Sprain is?

Ankle sprains are typically diagnosed by the healthcare professional based on how you injured it, the symptoms you report, and the physical exam to see which structures are involved. There are 3 classification groups that can identify how severe the injury is:

Grade 1:

• This is where the ligaments have been stretched beyond its normal length but rather than having a large tear, there are super tiny tears in the ligament instead.
• Symptom wise, you can experience a little tenderness around the ankle on touch, some swelling, and maybe some bruising (but not necessarily). There is very little loss of function with this grade so you can go about your day without any pain on weightbearing!

Grade 2:

• At this level, you would have a partial tear of the ligament.
• For symptoms, people often experience tenderness on touch, swelling and bruising at the ankle, pain when you put weight onto the ankle, and limited range of movement. You might even feel slightly less stable on the ankle.

Grade 3:

• This is the most severe classification, where you have a complete tear of the ligament.
• Here, people will report having significant levels of tenderness on touch, swelling and bruising around the ankle, and instability at the ankle. This grade is associated with a loss of function and therefore, it can be very painful when you try to put weight on it.

To put a timeframe on how long it typically takes to recover from an ankle sprain, it can range between 2 to 12 weeks. Most people are able to eventually return back to their day-to-day activities.

Can Physiotherapy Help my Sprained Ankle?

The answer is yes, absolutely! Conservative treatment is the way to go for ankle sprains! Although this injury is self-limiting, meaning it can eventually heal on its own, it is really important to still seek out proper treatment. Research has shown that having poor or delayed treatment can increase the risk of having recurrent ankle sprains in the future. This is something that we want to avoid because it can lead to ankle instability, arthritis around the ankle joint, and risks of chronic/long-term ankle pain.

Some of the main goals for rehabilitation of this injury includes reducing pain and swelling symptoms, promotion of healing for injured ligaments, and ultimately restoration of function for the ankle. When you visit a physiotherapist, they can work with you to see what type of treatment you need based on the severity of the injury. So what should you do first after sustaining the injury? For the next 48-72 hours, try RICE! RICE stands for Rest, Ice and Compression (to reduce swelling), and Elevation (above the level of the heart). If it hurts to put weight on your ankle, your physiotherapist can prescribe you with crutches or a walking boot until the pain settles down. You can also visit your local pharmacist or family physician to determine if over-the-counter medications (eg. Advil, Tylenol) are suitable for your pain management. Keep in mind that for the first 48 hours, you want no HARM (no Heat, Alcohol, Running or any similar activities, or Massages).

What’s next? Rehabilitation! Physiotherapists will create a program with you that will typically involve starting off with gentle range of motion exercises, followed by strengthening the surrounding muscles to provide more support for the ankle. By strengthening the muscles, it can help prevent recurrent ankle sprains because the muscles will provide that extra layer of stability for the joint. Additionally, balance will also be a priority, since it will improve something called “proprioception,” which is the ability to know where your limbs and joints are in space. Eventually, you will get to the “return to sport/activity” phase where the physiotherapist will help you get back to your everyday life. But remember, a gradual progression in your recovery is key! We want to avoid rushing the recovery process and really focus on strengthening and stabilizing the ankle in order to minimize the risk of reinjury in the future.

At Boost Physiotherapy, our physiotherapists are ready to assist you with any injury you may have! If you think you have sprained your ankle, talk to one of our physiotherapists and they will work with you to determine which treatment option best suits your needs based on the severity of your sprain. If you have any further questions about ankle sprains, book an appointment online or call us today at 587-635-5555 (South Edmonton) or 780-591-5555 (Stony Plain). Our physiotherapists will be happy to assist you in any way!