Sprained Ankle                     

An ankle sprain is one of the most common injuries to the ankle and can result in a loss of normal function for many weeks and months, although the severity does vary. It can lead to a range of symptoms from mild pain and swelling around the ankle that can get better within a few weeks to severe pain, swelling and bruising that can take months to heal. In severe cases a fracture of the ankle bone can also result.

The most common type of sprain occurs when the foot is forced inwards (inversion) usually caused by an injury, for example, tripping or misplacing your foot. The foot can be forced outwards (eversion), however, the ligaments that help to prevent this direction of movement of the ankle are much stronger and, therefore, this type of injury is much less common. It should also be remembered that although the ankle joint is where the lower leg attaches on to the foot there are other small joints of the foot that can be equally involved when an ankle is sprained.

When the ankle is sprained it causes a sudden and excessive stretch to all of the soft tissue structures that are situated around the ankle. These include ligaments that join bone to bone and support the ankle and muscle tendons that cross the ankle that are vital for normal movement. All of the structures are pain sensitive and, given the right amount of force, will become painful and inflamed.

Once the ankle has been sprained inflammation is triggered which represents the start, and a vital part, of the Healing process. Initially, the ankle becomes painful and may become quite swollen. At this stage the emphasis is on resting the ankle to prevent further injury, whilst applying ice for short periods only to help with the pain and swelling. Gentle movement of the ankle is beneficial to prevent it from stiffening up. Once this ‘acute’ phase is over it is necessary to gradually return to weight-bearing and walking, although it will still be painful at times.

What is a very common finding, however, for most ankle sprains is a reduced ability to balance afterwards. This is called proprioception. Around the ankle there are receptors that feed information back to the brain with regard to balance and joint position. This is essential for normal movement. An important part of the treatment and rehabilitation process is to identify if proprioception has been affected and to re-educate the balance system when necessary. Many a sprained ankle has healed but with a reduced ability to balance which has given longer term problems such as difficulty returning to a sporting activity, for example.

Physiotherapy treatment is aimed at promoting the tissue repair process to accelerate Healing as well as restoring normal range of movement and strength around the ankle and addressing decreased proprioception where necessary.