Managing Ankle Sprains and Strains

By Ryan Jones, DPT, CSCS
Jumpstart Physical Therapy

We've all done it before and it always seems to happen at the worst time. I'm talking about the dreaded ankle sprain...you know, when your foot turns in and your outer ankle rolls toward the ground? Whether you were out for a hike, playing a pick-up game of basketball with your friends or out for a night on the town in your favorite high heels, it seems as though everyone has hurt their ankle at least once -- if not a bunch of times. Sprained ankles are among the most common orthopedic injuries and the small ligaments in your outer ankle are the most frequently sprained ligaments in your body. 

About Ankle Injuries

The outer portion of your ankle is supported by three main ligaments. These ligaments are relatively small and come from the front, bottom and back part of your ankle bone and extend down to attach to your foot/heel bones. Your inner ankle has one large broad ligament, which is one of many reasons why this is a much more stable region and less susceptible to injury. The chief purpose of all these ligaments is to stabilize the ankle. When you sprain your ankle, you essentially stretch out and/or cause small tears within the ligament itself, which ultimately leads to some instability. Your body's ability to sense where it is in space, called proprioception, also becomes impaired after an ankle injury. The best way to minimize the long-term effects of an ankle sprain is to make sure you properly manage and treat your injury. 

First and foremost, RICE (Rest, Ice, Compression, Elevation) is always best. If you get significant swelling and bruising, heard a pop during the time of injury or have such severe pain that you cannot place any weight on your leg, get imaging as soon as possible to rule out a fracture. If you have sustained a mild sprain, sometimes a basic ankle brace is helpful to take stress off the ankle and to allow your ligaments to properly heal during the first few days. If it is still painful to walk, crutches can help alleviate pain for a few days as well. 

Early on in the healing process less is more - meaning use your injured ankle as little as possible. Follow this basic rule: if it hurts, don't do it! Your job is to protect those ligaments and let them heal as best they can. As the pain and swelling subsides, you should be able to walk relatively normally. At this point, doing some light transverse friction massage (http://www.sportsinjuryclinic.net/sport-injuries/ankle-achilles-shin-pain/sprained-ankle/sports-massage-ankle-sprains ) will help promote proper healing. Also, initiating some light ankle exercises with an exercise band can be very helpful (http://www.performanceorthopedics.com/protocols-exercises/physical-therapy-exercises/lower-extremity/ankle/).

Early performance of some basic balance exercises also is crucial to restoring proprioception and strength. These exercises should still be performed in a pain-free range. Pain in your outer ankle with any activity is a sign of negative stress and should be avoided. Early protection followed by an early exercise program can help greatly minimize the effects of an ankle sprain and minimize your risk for re-injury in the future.

As always, if you have any other questions, you know where to find us.