Dr. WildeAnkle Sprains: 101

Written by Dr. Jordan Wilde, DC

Milwaukie Spine and Sport

How Ankle Sprains Happen

It is a normal day. You are thinking about a hundred different thoughts at once, unfortunately one of those thoughts is not about where or how your foot is going to land on the ground. BAM, POP, now you mis-stepped and have rolled your ankle. Now the usually simple act of taking consecutive steps, a necessary part of walking, is out of the question due to the excruciating pain coming from your ankle. This is a familiar story for too many people and can occur in a lot of different circumstances ranging from the sports arena, city street, trail, or home staircase. Unfortunately, people who have hurt their ankle before, often feel long lasting residual effects from the injury. These include pain with activity, painful ranges of motion, a feeling of instability, and an increased chance of re-injury. The following will discuss the different types of ankle sprains, optimal first aid care, and the progressive rehabilitative exercises needed to completely heal from the injury.

Types of Ankle Sprains

Ankle sprains most often fit into two different categories; inversion where foot is twisted inward and eversion where your foot is twisted outwards. Inversion sprains tend to be the most common. The term sprain refers to an overstretching of the joint capsule and/or ligaments surrounding a joint. This overstretching results in the tearing of some, the amount depending on severity of the stretch, of the fibers of the joint capsule and/or ligament. Think of your ligaments, joint capsules, and muscles as being like a rope with many different individual strands woven together to make one strong structure. Often times a sprain will be associated with an overstretching and tearing of muscle or tendon that surrounds the joint, this is known as a strain.

The “PRICE” of Ankle Sprains

Sprains and strains result in swelling, inflammation, and muscle spasms. Limiting the extent of these undesired symptoms from the injury is the goal of first aid care. Remember the acronym “PRICE.” The first parts are “protect” and “rest,” limit your weight bearing activities and use a brace if there is a lot of swelling around the ankle or if it feels unstable. Next is “ice,” this will help limit the amount of the inflammation and swelling. Do not use heat as it will exacerbate the swelling and inflammation. Ice packs, ice massages, and an ice bucket to fully immerge the ankle are all good options and vary as far as application times and frequencies. Next is “compression,” use a wrap or some braces will work to provide gentle compression around the ankle. Finally is “elevation,” as often as possible lay or sit in a way that will allow your ankle to be higher than your heart. This will use gravity to help drain any swelling and inflammation that has accumulated out of the ankle.

Treatment of Ankle Sprains

First aid is important and will help you feel better much faster, if you are able to avoid letting the swelling, inflammation, and muscle spasms from getting out of control. However, to prevent future complications more work is likely needed. Rehabilitative exercises can be started within the same day of the initial injury but all exercises should not be performed before the body is ready for them. The first goal is to restore full active range of motion to the ankle joint. A popular exercise is to write the alphabet in the air using your ankle to perform the movements, both lower or upper case letters work. Once the range of motion of your injured ankle is equal to about 90 percent of the uninjured ankles range of motion, you are now ready to begin some strengthening exercises. These exercises will focus on restoring your balance and proprioception, the bodies ability to know where it is in space. They are as simple as standing on one leg. Start with your eyes open, you feel the muscles around your ankle twitching and working hard to try and keep you upright. As this becomes easier challenge yourself by closing your eyes or standing on an uneven surface such as a balance trainer. This is an important step of the rehab process because these muscles become weak from the injury and strength is needed in the muscles around the ankle to provide the stability needed to avoid future ankle sprains or rolls. A lot of recent research has shown balance training to be more effective than bracing to prevent future injury.

We have discussed the ankle sprains, the first aid to be performed in case of injury, and the rehabilitation protocol needed to fully heal from the injury. These injuries are common and the recurrence is far too common. Knowing what to do to promote healing is important but without follow through it doesn’t really help. So make sure to take care of your injuries. There are many professionals such as chiropractic physicians, physical therapists, and athletic trainers that are experts on this subject and working with them will help speed up your recovery and make sure that it is as optimal as possible. If you need help or have any questions the employees of Milwaukie Spine and Sport would be happy to help.