23 May Bringing the Ankle to Heal
Ankle sprain is an incredibly common injury that most people allow to heal on its own. In over 800,000 patients who reported for assessment of lateral ankle sprain, only 11% had rehabilitation codes associated with them (2016). So is ankle sprain a cause for concern?
Depending on the severity of the sprain, the ligament on the front and lateral side of the ankle can be strained or torn. These ligaments are known to have poor healing and this can lead to some instability of the ankle. The good news is that stability for everyday activity and sports relies a lot on coordination training or as we call it sensorimotor reorganization.
Due to the high incidence of ankle sprain, some studies have looked at the effectiveness of rehabilitation done at home. Home rehabilitation was found to be effective but rehabilitation in physical therapy was found to be more effective due to being individualized to specific deficits. Performing hands-on adjustments in physical therapy is shown to improve mobility which is key to proper foot mechanics. The exercises included in the self-guided program were one-leg knee flexing, toe stand, one leg stand, runners pose, cross legged sway, and toe walking.
If you’re not the type to want to seek rehabilitation for an ankle sprain, here are some researched reasons why you should change your mind:
If you participate in high impact sports such as tennis, soccer, or basketball
If you have poor one-legged balance (less than 30 seconds without touching)
If you have had a sprain before
If you have lousy follow through for doing your own program
If you continue to have foot and ankle pain when walking
In the event of an acute sprain, the use of an ankle support and early return to weight bearing is important, along with the usual recommendations of ice, elevation and compression. The type of support can be based on comfort and preference with more severe injuries requiring more rigid support. If you are completely unable to bear weight, you have severe pain when you touch your ankle bones and you have swelling greater than two centimeters when you compare your ankles, you should go to urgent care for assessment.
Ankle re-sprain incidence increases in athletes who don’t stretch before activity, those who have not participated in a balance/proprioception program, and those who don’t wear an ankle support during practice or competition. If you have any questions regarding your sprained ankle, don’t hesitate to call us for a free consultation.
Marin, Robroy et al. Ankle Stability and Movement Coordination Impairments: Ankle Ligament Sprains. J Orthop Sports Phys Ther. 2013;43(9):A1-A40. doi:10.2519/jospt.2013.0305
Jeff Houck, PT, PhD, Christopher Neville, PT, PhD, Ruth Chimenti, DPT, PhD The Foot and Ankle: Physical Therapy Patient Management Using Current Evidence. Current Concepts of Orthopaedic Physical Therapy 4th ed. January 2016.