Ankle sprain is a very common injury. Some studies have indicated that more than 1000 people will sprain their ankle every day in Australia.
How do I know if my ankle is sprained?
An ankle sprain occurs when we roll our ankle either inwards or outwards. This puts strain on the ligaments and tendons on that side of the ankle causing injury.
Ankle sprains can vary widely from a minor strain that gives pain for a few minutes and recovers within a day or two. They can also be very serious injuries that require a period of immobilisation and non-weight bearing and take months to recover.
What happens when I sprain my ankle?
We have 3 ligaments on the outside of our ankle which can often be damaged when we roll inwards. This is the most common ankle sprain (inversion sprain)
We have 1 large ligament on the inside of our ankle which can be injured when we roll outwards (eversion sprain)
A third category of sprain is a high ankle sprain where we injure the ligament and or fascia between our 2 shin bones (This is the dreaded syndesmosis, the curse of the NRL)
How long should it take for a sprained ankle to heal?
There are 3 grading levels for ligament injury:
Grade 1– minor damage to the ligament (up to 4 weeks healing)
Grade 2– large amount of damage to ligament but some fibres still intact (4-8 weeks healing)
Grade 3– Complete rupture. (>8 weeks healing)
These grading levels may not necessarily match up with the level of pain you feel, however they will impact your healing times.
Do I need an x-ray for my sprained ankle?
There are specific guidelines as to who should have a scan. If you are unable to weight bear initially and for a period after injury a plain x-ray is indicated to rule out a broken bone. Ultrasounds are often performed and can often overstate the grading of injury.
MRI is indicated if you fail to improve after 2-4 weeks of rehabilitation.
Surgery for ankle sprain is rare. Surgery would not be indicated based on imaging alone. Surgery is often performed if there is ongoing instability despite thorough rehabilitation.
What to do if you suspect you have sprained your ankle?
The R.I.C.E principle
Relative rest- don’t be afraid to weight bear if you can tolerate it. But limit walking too far if your ankle is too sore.
Ice- apply ice for the first 1-2 days. Ice the area in 10-minute increments
Compression- Apply a compression bandage early to limit swelling.
Elevation- Elevate your ankle above your heart.
When should I see a Physiotherapist for my Ankle Sprain?
Gold standard management would be to see a physiotherapist as early as possible after injury. A trained physiotherapist will be able to order imaging (if needed), supply you with a moon boot or crutches and educate you as to the correct early rehabilitation to perform after injury.
Often early intervention will cut down overall treatment and rehabilitation time considerably. This means less overall treatment, early return to sport or normal function and less time spent in pain.