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Ankle Sprains and Physical Therapy

What is considered an ankle sprain?

Sprained ankles are a common injury. Ankle sprains may be caused by falling, sudden twisting of the ankle, or stepping on an uneven surface. One of the most common ankle injuries is a lateral ankle sprain.

Causes of an ankle sprain

Understanding the risk factors of spraining your ankle can help you avoid an ankle sprain injury. There is an inherently increased risk of ankle sprains in individuals who:

  1. Have a history of a previous ankle sprain.
  2. Do not use external support (like a brace).
  3. Did not properly warm up with dynamic movement before activity.

How do you diagnose a sprained ankle?

  1. Pain, especially when you bear weight on the affected foot.
  2. Tenderness when you touch the ankle.
  3. Swelling.
  4. Bruising.
  5. Restricted range of motion.
  6. Instability in the ankle.
  7. Popping sensation or sound at the time of injury.

To regain proper levels of function, your therapist should diagnose properly before they prescribe.

How do you treat a sprained ankle?

How you should treat your sprained ankle depends on the severity of the injury. Mild to moderate sprains can be treated at home through the P.O.L.I.C.E. method (protect, optimal load, ice, compress, and elevate). While some ankle sprains need an examination and medical advice.

Should you tape or brace you ankle?

Two recent articles in the American Journal of Sports Medicine on ankle taping revealed that the application of tape actually decreased the ability to detect movements of the ankle. It was concluded that the efficacy of taping is unlikely to prevent an ankle injury as successfully as a brace with the figure 8 sub-talar locking mechanism, e.g., brands like ASO. A separate article mentioned that by the end of the first quarter of a basketball game, the traditional athletic taping of the ankle had the same restrictive abilities as a “tight sock”.

We are not saying taping is bad for ankles, but we are challenging the traditional beliefs in this being the golden standard. Our vote is to use a figure 8, stirrup ankle brace that locks the sub-talar joint. This will allow for longer-lasting ankle support throughout a ga

me and also removes the application error that is often seen in an ankle taping job.

When can I put weight on my ankle after a sprain?

Individuals with ankle sprains should use lace-up style external supports and progressively bear weight on the affected limb. The type of brace and gait assistive device recommended should be based on the severity of the injury, phase of tissue healing, level of protection indicated, the extent of pain, and patient preference. In more severe injuries, immobilization ranging from semi-rigid bracing to below-knee casting may be indicated.

At Wright Physical Therapy, we utilize mobility to stability inverse diagram to help guide this process for quicker and more effective healing.

Physical Therapist addressing patients pain

Ankle Sprains and physical therapy

 Manual physical therapy

Manual therapy procedures, such as lymphatic drainage, active and passive soft tissue, and joint mobilization and anterior-to-posterior talar mobilization can be very useful for healing. These procedures are performed within the pain-free movement, to reduce swelling, improve pain-free ankle and foot mobility and normalize gait patterns in individuals with an ankle sprain.

IASTM (Instrument Assisted Soft Tissue Mobilization) techniques are also effective in stimulating the damaged tissues and promoting healing.

Therapeutic exercises

WPT implements rehabilitation programs that include high-skilled and progressive therapeutic exercises for patients with severe ankle sprains. Utilizing phases of progression and test out criteria to guide this process is crucial in a full and safe recovery.

WPT uses weight-bearing functional exercises and single-limb balance activities (activity and sport-specific) using unstable surfaces in order to improve mobility, strength, balance, coordination, and postural control in the post-acute period of rehabilitation for ankle sprains.

When can you return to your sport after a sprained ankle?

Before considering returning to their sport the athlete needs to show proper progress and tolerance for dynamic and sport-specific exercises along with proper stability and control of the ankle. RTS protocols and testing need to be followed to ensure the athlete safely returns to sport with reduced risk factors for additional injury; this includes proper bracing or taping which was discussed above. Whatever bracing method is used, safety and reducing injury risk factors are the primary focus of the return-to-sport programs.

Conclusion

Mild to moderate ankle sprains often heal well with the P.O.L.I.C.E principle. For chronic instability or severe ankle sprains, advanced physical therapy is imperative for the long-term success of daily activities or sports. Specific protocols, proper bracing, and return to sport testing are a necessity to safely return to sports.

Call us today at one of our convenient clinic locations to get to the root of your pain.