Untreated ankle sprains can create long term issues

I recently came across a good newspaper article about ankle recovery and prevention and it has prompted me to write this blog because I believe many people don't take ankle sprains seriously enough and they have the potential to cause serious long term issues such as Chronic Ankle Instability and Osteoarthritis.

So what is an ankle sprain?
A sprain is an overstretching or tearing to a ligament; the thin strap that holds bones together.  A ligament is less elastic and has a poorer blood flow than a muscle or tendon and therefore tends to heal slower.

The most common ankle sprain occurs when the ankle rolls outward and the foot turns inward. An Inversion Sprain.  It results in stretching and tearing of the ligaments on the outside of the ankle.

Less commonly, the ankle rolls inward and the foot outward in an eversion injury, damaging the ligaments at the inside of the ankle. 

The high ankle sprain is the least common. It can happen when the foot is forced to rotate toward the outside (away from the other foot), or when the foot is planted so it can't move and the leg is rotated toward the inside.

How severe is your ankle sprain?
There is a generalised grading system for ankle sprains:

• Grade I is stretching or slight tearing of the ligament with mild tenderness, swelling, and stiffness. The ankle feels stable, and it is usually possible to walk with minimal pain.
• Grade II is a larger but incomplete tear with moderate pain, swelling, and bruising. Although the ankle sometimes feels stable, the damaged areas are tender to the touch, and walking is painful.
• Grade III is a complete tear of the affected ligament or ligaments with severe swelling and bruising. The ankle is unstable and may feel "wobbly." Walking is usually not possible because the ankle gives out and there is intense pain, although initial pain may quickly subside.

How long does it take to heal?

Research shows that it take ankle ligaments about 4-6 weeks and up to 12 weeks to heal completely but I always say "how long is a piece of string?!"  Everyone is different and how you choose to approach rest, exercise and treatment all has an impact upon recovery

What exercise can you do?

• For grade 1 and 2 sprains the best course of action would be immobilisation with boot or brace and RICE treatment initially then early range of motion exercises without weight bearing. The boot/brace/tape serves as a scaffold for the ankle so that the injured ligament can heal in the appropriate position and scar tissue that forms around the injured ligament can form in an anatomically correct position. Early weight bearing out of the boot/brace/tape puts patients at a very high risk of re-injury. 
• After you are able to place your full weight on the injured ankle without pain, you may begin proprioceptive training to regain balance and control of the ankle joint.  Proprioceptive and balance exercises teach your body to control the position of a deficient or an injured joint (ankle). Swimming is also good.
• Activities such as jogging, running and cycling should only take place once your ankle is stable enough to balance on for 3 minutes without pain.

How can a sports massage therapist help?
Sports massage can help reduce swelling and increase blood flow to the injury site.  This can speed up the healing process as it increases the flow of natural nutrients to the area, reduces the build up of scar tissue and aids mobility.
The therapist should also be able to guide you through a structured exercise rehabilitation program tailored to your specific injury and need to return to work or sport.

In short....
Don't just wait for your ankle sprain to heal on its own; seek appropriate treatment and advice from a trained professional!