Ankle sprains- our top tips
Rolled your ankle, well you're not alone....
Some quick stats (everyone loves a stat)
Ankle injuries are the most common injury in sports & recreational activities in NZ (20% of all sporting injuries)
75% of all ankle injuries are sprains
85% of sprains result from inversion trauma (rolling inwards)
20-40% experience chronic instability
Netball and football very common sport for knee and ankle injuries
Ankle and knee injuries constituted 47% of all netball injury claims in 2017 and 66% of the cost of netball injuries to ACC at NZD$18,049,370,
10% presentations to A+E departments
Is yours minor or more problematic?
Key questions to ask yourself when it first happens:
Could you stand on it straight away or was it too sore?
Was there significant swelling and bruising?
When to seek treatment:
Well, if it was too sore when trying to put your weight through it when it first happened and you experienced swelling and bruising, then get it assessed and treated.
Ongoing pain and loss of motion also is a sign that there is an ongoing problem.
Severity and approximate recovery timeline
SEVERITY: Grade 1
DAMAGE TO THE LIGAMENTS: Minimal stretching, no tearing
SYMPTOMS: Mild pain, swelling, and tenderness. Usually no bruising. No joint instability. No difficulty bearing weight
RECOVERY TIME: 1–3 weeks
SEVERITY: Grade 2
DAMAGE TO THE LIGAMENTS: Partial tear
SYMPTOMS: Moderate pain, swelling, and tenderness. Possible bruising. Mild to moderate joint instability. Some loss of range of motion and function. Pain with weight-bearing and walking
RECOVERY TIME: 3–6 weeks
SEVERITY: Grade 3
DAMAGE TO THE LIGAMENTS: Full tear or rupture
SYMPTOMS: Severe pain, swelling, tenderness, and bruising. Considerable instability and loss of function and range of motion. Unable to bear weight or walk
RECOVERY TIME: Several months
Our top tips
RICE (Rest, Ice, Compression Elevation) - classic but timeless advice, icing for 10-15 mins max at a time.
Why RICE?
This is aimed to reduce swelling and pain, support the injured tissue to allow the healing process to start.
Support with bandage and as soon as you're able start progressive weight bearing
Get it moving
We want to get normal function back as early as possible
Keep you ankle moving even when sitting
Start relearning your balance as soon as possible and we want you to get out of a limping pattern as soon as is comfortable.
Treatment - what are our aims?
Our initial assessment is designed to rule out more significant damage such as fractures and design a program to get you moving as early and as safe as possible.
Hands on treatment as early as possible to clear swelling and restore ankle movement.
Help with normalising walking patterns.
Joint mobilising and home exercise program that will include protected active movements, stretching exercises, neuromuscular training, postural re-education, and balance training.
As you improve we progress onto functional and sports specific rehabilitation and training i.e if you want to get to running, netball, soccer, rugby etc, your rehabilitation needs to be guided around reproducing those movements safely before you get back to full exercise.
Interesting notes (well for geeky physios that is....)
Very rarely a moonboot is needed, and if so, the use of a moonboot beyond 10 days – 2 weeks is NOT recommended
X-rays are helpful, but ultrasound imaging not recommended
The use of Therapeutic ultrasound (the old machine with the blue gel 90's & 00's style of physio) is NOT recommended anymore.
