Whether you have sprained your ankle for the first time or have been dealing with ankle sprains for years, this blog will help you understand what happens during an ankle sprain and how to treat it, both acutely and in chronic cases.
There are two main types of ankle sprains, lateral and medial. The lateral ankle sprain is the most common, accounting for about 85% of cases, while medial ankle sprains make up about 5%. The other 10% are high ankle sprains, which are more complex and won’t be covered in this blog. A medial ankle sprain, or eversion sprain, occurs when the inside of your ankle moves towards the ground and your toes move towards the outside of your foot. A lateral ankle sprain, or inversion sprain, is the opposite; it occurs when the outside of your ankle moves towards the ground and your toes go inwards.
Most people who experience an ankle sprain have a lateral ankle sprain, which involves stretching or tearing of the ligaments on the outside of your ankle. These injuries are generally graded on a 1-3 scale with three being most severe. Recovery times can vary; 1-3 weeks for a grade 1 injury, 2-6 weeks for a grade 2 injury, and 6-12 weeks for a grade 3 injury. These timelines are also affected by your activity level; it is much easier to return to desk work than high-level sports. The grading scale is based on the level of tearing of the ligaments in your ankle, with grade 1 being stretching of the ligament with minor tearing, up to a complete rupture with a grade 3 ankle sprain.
When an ankle sprain first happens, it can be a painful and surprising occurrence. Knowing what to do or where to start can be difficult. While you should always see a medical professional if you are concerned about your injury, there are signs to look out for that would raise the level of concern for a possible fracture. These are called the Ottawa ankle rules: inability to walk 4 steps after the injury and about 30 minutes later, tenderness along the last 6 cm of your inner ankle bone, tenderness along the last 6 cm of your outer ankle bone, tenderness at your navicular, and tenderness at the base of your pinky toe (5th metatarsal).
If any these describe your symptoms then it may be extra prudent to go to urgent care for further evaluation.
If your symptoms do not fall into those categories and you don’t feel that you need to seek further treatment, you can start the recovery process. For the first few days, take it easy, focusing on activities that you can do without pain. Depending on the severity of your injury, you may be able to start walking right away. If you can do so without increasing pain or swelling, gradually build up your walking volume over a few days. An ankle brace, such as a lace up brace, can provide extra support. If your injury is more severe, you may need to spend a short amount of time on crutches before you can walk without an adverse reaction. While ice is often used after an injury, evidence shows that it is not especially effective in improving function alone. Current recommendations are to use ice if desired in combination with an exercise program but not as a stand alone treatment.
As your pain and swelling decrease, the focus of treatment should shift to therapeutic exercises, including stretching, strengthening, and balance work. Initially, your ankle may be stiff due to swelling and decreased activity. Start with ankle ABCs, writing out the alphabet with your toes to move your ankle through a large range of motion. Calf stretching is also a gentle way to start working on your ankle mobility.
Over time, work on improving your ankle’s flexibility and leg strength with exercises like lunges and deficit heel raises. Regaining strength in your ankle and the rest of your leg is crucial. Start with banded ankle exercises, moving your toes in, out, and up against a band. As your symptoms allow, add in challenging exercises like squats, lunges, and RDLs.
Finally, incorporate balance tasks into your exercise routine. Start by standing on one foot with your eyes open and progress to variations like standing on a foam pad or other unstable surface, standing with your eyes closed, and using objects to challenge your balance, such as throwing a ball.
Incorporating these exercises into your recovery should help to speed up the timeline and get you back to doing what you love faster!
Unfortunately, some people may experience recurrent ankle sprains and feelings of instability after an initial lateral ankle sprain, referred to as chronic ankle instability. This can lead to issues during sports and daily life if the instability is severe. Generally, there is less swelling with each ankle sprain as there is less tissue damage, which can help you return to activity sooner. Treatment for chronic ankle instability is similar to that for an acute ankle sprain, and may involve ankle strengthening, leg strengthening, balance training, and even jumping. It is important to remember to stay active by continuing to walk and engage in activities that you feel safe doing. Wearing a lace-up ankle brace can also provide extra stability during these activities.
After an ankle sprain, seek medical attention as necessary to rule out fractures, followed by gradually increasing your activity with easy movements like walking and ankle alphabet exercises. As your symptoms improve, progress your exercises to more challenging activities like weight training, balance work, running, and jumping until you are ready to return to your desired activity level. Whether you just sprained your ankle or have been dealing with chronic ankle sprains, contact our specialists at Maven to make an appointment today and guide you back on your journey to 100%.
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