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Ankle Ligament Injury

Sprained Ankle Treatment

Minute Read

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Posted 6 months ago

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Last updated: 03/12/2022

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by James McCormack

Sprained Ankle Treatment

A sprained ankle is one of the most common types of musculoskeletal injury. In this article, we aim to cover all forms of treatment that one might receive under the care of a Physical Therapist or Sports Doctor. If you would some guidance on home treatment for a sprained article we have covered that in detail here. We cover treatment for a low ankle sprain in this article. If you suspect that you have a high ankle sprain, please read our other article for treatment guidance.

How Long does a sprained ankle take to heal?

The time it takes for a sprained ankle to heal is dependent on the severity of the sprain and how it is managed in the acute stages of injury. We recommend seeing a Physical Injury from day 1 on injury where possible, if this is not an option we suggest applying the PEACE & LOVE acronym until you can seek medical attention.

Grade 1 Ankle Sprain

This is regarded as an overstretching of the ligaments rather than a tear. These can heal within 2-14 days if managed with the PEACE & LOVE strategy.

Grade 2 Ankle Sprain

A grade 2 ankle sprain is a partial tear of the fibers of the ligament, usually up to 50% of the fibers. It takes 4-6 weeks for the ligament to physiologically heal but it can take longer for complete recovery if the correct management is not followed.

Grade 3 Ankle Sprain

A grade 3 ankle sprain can take 6-12 weeks to heal. It is very important to see a Physical Therapist for this injury as the healing process is slow and secondary injuries can occur to the lengthy nature of this recovery.

Physical Therapy for Sprained Ankle

There are numerous forms of Physical Therapy for ankle sprains so we will try to split them into categories to provide clarity on what comprehensive treatment for a sprained ankle consists of. If you would like information on home remedies, we have covered that in another article.

 

Sprained Ankle Massage

Massage is an effective form of pain relief for a sprained ankle and should be applied throughout the recovery process. Immediately post-injury inflammation and swelling occur as part of the healing process which is natural and should be controlled with elevation and compression of the ankle.

From day 3 onwards, gentle massage of the ankle with techniques such as effleurage is helpful to flush out excess swelling. Deep tissue massage can be applied to the surrounding muscles such as the Calf, Peroneal, and Posterior Tibial muscle as these become tight and restrictive as they try to protect the area of injury.

Effleurage to the ankle should be from distal to proximal with greater pressure being applied as the injury progresses beyond one week. Your ankle sprain massage can then be progressed into a more dynamic massage consisting of all massage techniques to assist a return to the full range of motion to the ankle.

Sprained Ankle Brace

An ankle brace for a sprain is highly effective in protecting the joints and ligaments in the early stages of healing. It reduces the risk of further injury by holding the ankle in a neutral position and is used in elite sports immediately for all grades of injury. In the general population, they are mostly used for grade 2 and grade 3 ankle sprains to help mobilize the ankle with minimal discomfort. An ankle brace for a sprained ankle is normally worn for the first 2-4 weeks depending on the severity of the sprain. We have carried out an extensive review of recommended ankle braces here.

Ankle Sprain Taping

Rigid taping using zinc oxide tape is highly effective at offloading an injured ligament from an ankle sprain. This is normally performed by a Physical Therapist in the acute phase of the injury for all grades of an ankle sprain. It is normally performed using a figure 6 or figure 8 ankle lock technique which reduces the stress being placed on an ankle ligament when walking. This is an excellent form of pain relief in the early stages of injury.

KT Tape for Ankle Sprain

There is minimal high-level evidence to support the use of KT Tape when treating an ankle sprain. There are some poor-quality studies that conclude it can reduce swelling and improve range of motion in acute and chronic ankle sprains. However, our clinic findings have not demonstrated this and we are yet to see any high levels of evidence to support its use.

Sprained Ankle Crutches

In the general public crutches are only recommended for those that are unable to weight bear with a sprained ankle due to high levels of pain. Clinically, this is often for those with a Grade 3 Ankle Ligament Sprain. Partial weight-bearing with crutches and an ankle brace or boot can be used in the acute phase of injury but should be quickly weaned down to full weight-bearing to reduce the risk of compensatory injuries.

Boot for Sprain Ankle

In professional sport, athletes normally go straight into an air cast boot when they have an ankle sprain. This is to protect the ligament and there is some evidence that holding the ankle in a neutral position may facilitate the ligament recovering in a more optimal position. In the general public, a walker boot is mostly used for high-grade 2 or grade 3 ankle sprains. They are designed so that walking short distances is feasible but should not be used for walking all day. You should stay in a walking boot for a sprained ankle for 2 weeks before weaning out of it, typically indoors first but this is normally guided by your Physical Therapist. View our recommended boots here.

Sprained Ankle Exercises

A thorough rehabilitation program for a sprained ankle should be progressive and varied. This is important to regain the strength and balance that you have lost from the injury and to reduce the risk of reoccurrence.

Early-stage exercises normally involve some single leg balance exercises alongside so theraband strengthening of your ankle stabilizer muscles.

This progresses into weight-bearing exercises such as calf raises, star excursion balance, and stretches for the calf and soleus muscles to ensure a return to full ankle range of movement.

In the final stages of ankle sprain rehabilitation there are hopping and plyometric exercises alongside dynamic balance exercises on a Bosu ball and if required, sports-specific rehabilitation.

Physiotherapy with James McCormack

This is not medical advice. We recommend a consultation with a medical professional such as James McCormack. He offers Online Physiotherapy Appointments for £45.

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