Sprained Ankle
What Is A Sprained Ankle?
A sprained ankle is the term used when the ankle is overstretched or twisted and there is damage to the soft tissue around the joint, specifically the ligament. When the ligament is damaged there is an inflammatory response, usually swelling and bruising as the ligament begins to repair. Initially there is ankle pain and stiffness but these symptoms settle as the ligament heals. Sprained ankles are one of the most common sports injuries we see at The Physiotherapy Place, in fact most people who have played an impact sport such as football, hockey, or basketball will have sprained their ankle at some point in their lives.
How Do I Know If I Sprained My Ankle?
It is normally quite obvious when you have sprained your ankle. Some of the signs and symptoms of an ankle sprain are:
feeling a tear or pop the moment you damage it
some swelling or bruising around the ankle or foot (this isn’t always the case)
the ankle will be tender to touch
sharp pain when walking or moving the ankle in certain directions
stiffness after rest or first thing in the morning - this will improve once the initial inflammation has settled
Do Sprained Ankles Bruise?
Not always. A Grade 1 ligament sprain is when a few of the fibres within the ligament are overstretched but there isn’t necessarily any tear that would warrant bleeding. In this case there might not be much bruising or swelling but the ligament still needs time to heal and strengthen.
How Long Should It Take For An Ankle Sprain To Heal?
There are broadly 3 degrees of ligament sprain - Grade 1, 2, and 3.
A Grade 1 is mild when a few fibres are disrupted and this should heal with 2-3 weeks.
Grade 2 is a partial tear, so there is more damage and therefore more inflammation. These typically take 6-8 weeks to heal although tissue strengthening continues even after this time.
A Grade 3 tear is a complete rupture of ligament and this can take up to 12 weeks to heal. Occasionally this severe degree of sprain may require surgery to stabilise the joint again.
Can A Sprained Ankle Heal Itself?
Yes it can and often does. As long as there isn’t severe damage and you follow the correct rehab procedure, the ligament will usually heal itself. Problems can arise if there is residual instability from incorrect healing, if there is excessive scar tissue, or if there are other complications from the sprain such as adjacent joint stiffness or damage. If any of these complications occur then you should seek guidance from a physio.
What Happens If An Ankle Sprain Goes Untreated?
Often the ligament will heal well if the conditions are right. However if there are any complications such as instability or scar tissue then the ankle is unlikely to get back to 100% without help. I usually say to people that if you are self-monitoring your sprained ankle and it doesn’t feel good at the six week mark then you should seek advice from a physio as it likely requires some additional treatment.
Can You Walk On A Sprained Ankle?
Yes it is good to weight bear on a sprained ankle as soon as it is comfortable to do so. This doesn’t mean that you should walk through pain but it is good to try to mobilise the ankle early if possible in order to stimulate healing and prevent scar tissue building up. As the ligament is healing, walking is a good exercise to both mobilise and strengthen the ankle.
What Exercise Can I Do With An Ankle Sprain?
Initially it is good to try to keep the ankle moving, for example you can gently circle your ankle and move it up and down.
As the healing progresses, it is important to retrain your balance by standing on one leg and it is also good to stretch the calf muscle at the back of the leg.
Low impact activities such as walking, cycling, and swimming can be commenced as pain permits.
Finally, strengthening the muscles around the ankle to support the healing ligament e.g. heel raises.
What Will A Physio Do?
A physiotherapist will assess all of the ligaments in the ankle to determine which one(s) are damaged. Initial management will involve reducing the swelling with massage, mobilisation and ultrasound. Specific friction massage can be introduced to stimulate optimal healing of the ligament and break down scar tissue. Alongside all of this, specific exercises will be given at the correct time to promote balance and flexibility and most importantly strengthen the ankle to guard against further sprains.