Although not quite as serious as a break, a sprained ankle can still cause a lot of pain, swelling and discomfort. A sprain is a part or complete rupture of a ligament that holds the bones in the ankle together, causing them to feel strong and stable. 
 
Sprains can be tricky to rehabilitate fully after injury due to poor blood supply, meaning the healing process is slowed down. If rehabilitation is put in place and strictly followed, a sprained ankle can heal well – but not looking after a sprain correctly can lead to further, more serious injuries. 
 
Ankle sprains are a very common injury in both sports and everyday life. Most of us have experienced painful twists, tripping on uneven pavement, treading incorrectly down curbs or ‘going over’ in high heels. The most common ankle sprain is known as ‘inversion’ or ‘lateral’, which is the outside ligament. This accounts for around 85% of sprains. 

Risk factors 

Ankle instability is the number one factor of sprains. Luckily, ankle stability is something that can be assessed, so you can make a special effort to avoid injury should you have unstable ankles. Stability exercises can also be practised to decrease the risk of injuries. 
 
A history of spraining your ankle can, unfortunately, weaken the ligaments around the ankle that provide strength and support. This is one of many reasons why rehabilitation is important and should be followed immediately. 
 
Intrinsic factors such as height, weight, body sway, and the structure of your foot can mean you are more predisposed to getting sprains. Extrinsic factors would also include the type of shoes you wear, how much activity you do and the intensity of that activity. 

How do you know if it’s a sprain? 

The severity of sprains is graded from 1 to 3. 
 
Each grade tends to have worsening symptoms and will determine which treatment plan needs to be put in place. The first signs of a sprain are usually pain, tenderness, weakness, swelling and bruising. 
 
Grade I: Mild - Little swelling and tenderness with little impact on function. 
 
Grade II: Moderate - Moderate swelling, pain and impact on function. Reduced proprioception, Range Of Movement, and instability. 
 
Grade III: Severe - Complete rupture, large swelling, high tenderness, loss of function and marked instability. 

How does the common lateral sprain happen? 

Lateral sprains normally occur when our body weight quickly shifts over our landing or weight-bearing foot. We roll our ankle which stretches the lateral ligament and tears it. 
 
Strangely in a 1994 study, Yeung et al, found that a person’s dominant leg is 2.4 times more vulnerable to sprains than the non-dominant leg. You’d think it would be the other way around, but it’s not. 

How does the common lateral sprain happen? 

A sprain is likely to be very sore and visible swollen for the first few days. At this point, it’s classed as an acute injury, so manual therapists shouldn’t touch it for the first 48-72 hours. During this time you should follow the P.R.I.C.E principles for relief at home. 
 
P – Protect the injured area and avoid load-bearing 
 
R – Rest 
 
I – Ice 
 
C – Compression 
 
E – Elevation 

What can a therapist do for a sprained ankle? 

In order to establish which ligaments are causing your pain, your therapist will perform a number of tests such as evaluating the way you stand and walk, and look for swelling and bruising around the ankle. Once your therapist has a good idea of which areas need working on, they can begin to treat the injury. 
 
The most common massage techniques for sprains include a combination of massage such as cross fibre frictions. This technique breaks down any scar tissue that may have formed and encourages more blood flow to the area to aid healing. 
 
Effleurage flushes out all the debris and stimulates healing and k-tape (therapeutic kinesiology tape) can often help support the joint in between sessions. Correct taping also gives support to muscles by improving the muscle's ability to contract, even when it’s weak, and helps the muscle to not over-extend or over-contract. 
 
You may also be given exercises to build the ligaments back to their pre-injury condition. 
 
To help prevent these sprains from re-occurring, the best thing to do is make sure you stick to your rehab programme and don’t go back to your activity too soon. 
 
To book an appointment with one of our therapists, contact us today. 
 
Tagged as: ankle, foot, injury, sprain
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