Ankle Sprains

General information

There are different types of ankle sprains. They depend on the type of trauma/ direction of the ‘fall’

They are graded based on the following: bruising, swelling, ankle movement, weight bearing and limping

These details give an indication of recovery time and could between 1 – 8 weeks (pain free) to a 1 month – 1 year. The range is so large due to the difference in grading, however longer times account for structural recovery – bones, muscles, ligaments etc

Causes include awkward landing on the foot, muscle imbalances (weak or tight muscles on one side) or previous injury altering gait/foot positioning

Treatment options

Can usually be self-managed.

Early rehab considerations include rest; to reduce any weight bearing activities. Standard advice often suggests the application of an ice pack for the first 24 hours, for 20min every 1-2 hours and elevating the foot to rest and reduce oedema where possible. The evidence of this is unclear.

However, there is good evidence for early pain relief and mobilisation (pain free movement) as soon as possible. For example, sitting in a chair and gently moving the ankle.

Following from this, there is evidence that manual therapy and prescriptive exercises are also worth considering. The idea of this would be to increase movement and reduce pain.

Other considerations in the long run are strengthening specific muscles (depend on the individual) and using balance drills/exercises

Manual Therapy like Chiropractic

Taking into account the possible causes – awkward step, muscle imbalance etc, it may be worthwhile considering an alternative therapy such as chiropractic or consider pilates/yoga to rebalance the body

Contact your GP if

You are showing no signs of improvement or even getting worse. There is a possibility you may have broken a bone. You have a high temperature or feel hot and shivery. The area around the ankle feels cold or numb.

References and images

Biel A; Trail Guide to the Body 3rd edition

Carnes M Dr and Vizniak N Dr; Conditions Manual 3rd edition

Doherty C, Bleakley C, Delahunt E and Holden S; Treatment and prevention of acute and recurrent ankle sprain: an overview of systematic reviews with meta-analysis. Br J Sports Med, 2017 Jan;51(2):113-125. doi: 10.1136/bjsports-2016-096178. Epub 2016 Oct 8.

Souza TA; Differential Diagnosis and Management for the Chiropractor. Protocols and Algorithms 4th edition

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