At The Physiotherapy Place, sprained ankles are one of the most common sports injuries we treat, although they can occur doing everyday activities too. A sprained ankle occurs when the ankle is overstretched or twisted and there is damage to the surrounding soft tissues, specifically the ligaments. Ligaments are bands of connective tissue that help to stabilise joints. The most common type of ankle sprain is a lateral ankle sprain. This is where the ligaments of the outer ankle are injured.
What are the main muscles of the ankle?
There are several muscles of the ankle that give the ankle its strength and movement. The main muscles we assess are:
Calves (gastrocnemius and soleus) - The calf muscles at the back of your lower leg, allow you to point your foot down, or raise up on to your toes if you are standing.
Tibialis anterior – This muscle runs along your shin at the front of your leg, and allows you to bring your foot up.
Tibialis posterior – This muscle runs along the inside of your ankle and lower leg, and allows you to turn your foot inwards, as well as supporting the arch of your foot.
Peroneals (peroneus longus and peroneus brevis) - These muscles are on the outside of the ankle and lower leg, and allow you to move your foot outwards.
The peroneal muscles are of particular importance for lateral ankle sprains, as they work together to provide stability at the outer ankle when you have a sudden inversion stress. This is when you roll your ankle, stretching the ligaments of the outer ankle.
Sprained ankle recovery
The length of time it takes for you to recover from a sprained ankle will depend on the severity of your injury. Ligament injuries can be graded as 1, 2 or 3.
Grade 1 (mild) – damage to a few fibres of the ligament
Grade 2 (moderate) – partial tear of the ligament
Grade 3 (severe) – complete tear of the ligament and instability of the joint
Mild to moderate sprains will usually heal within 6-8 weeks, whilst a severe sprain may take 3 months or more.
It is important that ankle ligament injuries are fully rehabilitated, regardless of severity, otherwise there is a higher risk of reinjury in the future. This could lead to chronic issues if you have several sprains at the same ankle or if the ankle isn’t fully recovered after a sprain.
The main aims of rehabilitation for a sprained ankle are:
Reducing pain and swelling
Restoring range of motion
Regaining strength
Improving balance
Returning to normal activities and hobbies
Ankle sprain exercises
Range of motion (ROM) – After an ankle sprain, you may have restricted movement so it is important to restore this. Try gently moving the ankle up and down and in circles within a comfortable range. It is also good to stretch out the calf muscles.
Strength – As healing progresses, you can start strengthening the ankle muscles. Initially try some isometric exercises, where you engage the muscles without producing movement. Once your movement and pain are improving, you can add a resistance band to your ankle movements. Once able, performing calf raises where you raise up on to your toes, is another good strengthening exercise following an ankle sprain.
Balance – You might feel unsteady when standing on the leg of your injured ankle. Improving your balance is important after an ankle sprain, especially within sports where you are changing direction or are on uneven ground. A simple but effective balance exercise to start off with is a single leg stand on the injured leg.
When to start your exercises after a sprained ankle
Although the ankle needs time to heal, it is important to restore movement and strength at the ankle. You may need to have a few days rest after the initial injury, but getting started with gentle exercises early will help with recovery, and reduce the likelihood of future sprains. At The Physiotherapy place, we will get you started early on with the correct treatment and the correct exercises your pain allows and progress them as appropriate.
Is it ok to exercise on a sprained ankle?
Getting started with some aerobic exercise a few days after the injury, as pain permits, increases blood flow to injured structures and stimulates healing. We recommend lower impact activities that will allow you to keep your fitness up without placing too much stress on the injury. Activities such as walking, swimming and cycling are good options.
These will help with restoring movement and reducing swelling. Start off slow and easy before gradually building up.
Returning to some sports, especially those that are higher impact and have changes in direction will take longer. It is important that you are pain free, and have good movement and strength at the ankle before returning to these kinds of activities. If you return too quickly and haven’t fully rehabilitated the ankle, you will be more likely to injure the ankle again.
Towards the end of your rehabilitation, you will be given more sport specific exercises by your physiotherapist to ensure a safe gradual return to your sport, without increasing the chances of suffering from another sprain.
Do I need an X-Ray after an ankle sprain?
Most ankle sprains don’t require an X-Ray. However, sometimes in more serious injuries, there can also be fractures of the bones of the ankle and foot. Your physiotherapist will be able to assess your ankle and determine whether or not an X-Ray is recommended.
If you have injured your ankle and can’t put any weight on it, it looks deformed or you have numbness in the foot, then seek medical attention straight away.
Key messages from this blog:
Get the ankle moving early
Start low impact exercise as pain permits
Fully rehabilitate the ankle to decrease risk of further injuries
Can Physio help…
If you are suffering with ankle pain or any discomfort we at The Physiotherapy Place are here to help. Book an appointment or FREE phone call consultation with us and let us help you get back to health!