Ankle sprain

What is an ankle sprain?

It is a stretch or tear of one or more ligaments in the ankle joint.

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A lateral sprain is the most common, involving injury to the ligaments on the outside of the ankle.

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What is a ligament?

A ligament is a tissue that holds bones together. We have hundreds of ligaments in the body between each of our bones to stabilize them.

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What are the causes of an ankle sprain?

A sprain is always caused by an accident, trauma, or twist. There must be a clear traumatic event. Common causes of ankle sprains include:

• Falling on a foot turned inward
• Taking a misstep and landing on our foot turned inward

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« The most frequent ankle sprain is caused by an inversion movement, that is, the foot turning inward. However, an ankle sprain can also occur with excessive outward movement of the foot, or when the foot remains stuck on the ground and the body rotates inward. »

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So, if the pain appeared slowly and gradually, without any clear accident, it is not a sprain.

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What are the symptoms of an ankle sprain?

The common signs and symptoms are:

• Ankle pain after trauma
• Generally, the pain will be mainly in the front and on the outside of the ankle.
• Swelling of the ankle that may appear immediately or in the following hours.

• If it is a minor sprain, it is very possible that there will be no swelling.
• There may be redness and warmth of the ankle, which generally lasts 48 hours after the injury.
• Bruising on the ankle and foot if there has been significant bleeding from the ligaments.
• Mild to significant difficulty putting weight on the foot.

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Depending on the severity of the sprain, painful movements may vary from person to person.

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How to diagnose an ankle sprain?

Diagnosis is possible with the history of the injury, the symptoms, and a clinical examination. It is important to rule out the risk of ankle fractures. 

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In some cases, an X-ray will be necessary to ensure there is no fracture. Your physiotherapist will be able to tell you if an X-ray is needed.

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When to consult a physiotherapist for an ankle sprain?

You should consult a physiotherapist as soon as possible after the sprain.

You can even consult your physiotherapist the same day!

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"The first few days after a sprain are very important, and it is essential to know how to properly manage the injury to recover as quickly as possible."

You do not need to see a doctor before consulting a physiotherapist. If your condition requires you to see a doctor, your physiotherapist will be able to tell you.

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What are the physiotherapy treatments for an ankle sprain?

As with all traumatic injuries, we must allow the body to do its natural healing work.

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"Inflammation is a normal and necessary process for proper healing. There is no miracle cure to speed up healing."

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However, it is very important to eliminate any factors that could slow down healing. Here are some examples of things that could slow down healing:

• Worries or fears related to the injury or pain
• Improper dosage of exercises and daily activities
• Poor biomechanics of your movements
• Stiffness in the joints or muscles

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For this reason, your physiotherapist can help you optimize the healing of the injury. They will guide and support you in the best possible direction to ensure the injury heals effectively. 

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Think of healing from a traumatic injury like taking care of a plant. Pulling on the plant won't make it grow faster. However, you can make sure it gets enough water, sunlight, and fertilizer. We want to put the plant in a good environment to heal. It's the same for a traumatic injury.

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Your physiotherapist will perform a complete assessment to determine the limitations and ensure there is no risk of having suffered a fracture.

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They will give you instructions to follow for the acute inflammatory phase in the first few days. Your physiotherapist will advise you on the following:

• The use of crutches, a splint, or a bandage.
• Permission to put weight or walk on the foot.

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Then, your physiotherapist will guide you through an exercise program to regain flexibility, strength, stability, balance, and control of your movements.

They will guide you in managing your return to sports and other leisure activities, and provide advice to help you perform your daily activities and hobbies more effectively.

In the clinic, your physiotherapist can treat stiffness in the ankle, muscles, and nerves.

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What can you do at home for an ankle sprain?

Temporarily reduce the amount of time you spend doing activities that cause too much pain, and then gradually resume them.

Here are some tips that may help:

• Engage in activities that reduce stress on the area, such as swimming.
• Take frequent but short breaks in a seated position if the pain increases when you walk or stand for long periods.
• Wear wider shoes with thicker soles temporarily, or even sandals without straps if needed.

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If you don't see any improvement after 10 days, you should consult a physiotherapist.

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If you are a runner, refer to the blog post on running (link to come) for specific running tips.

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To learn more...

You can listen to the podcast PARLE-MOI DE SANTÉ created by one of our physiotherapists, Alexis Gougeon.

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Episode #1 discusses the prevention and treatment of running injuries.

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Find the episode on YouTube:

Click below to listen to episodes on podcast platforms:

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Sources

• Vuurberg G, Hoorntje A, Wink LM, Van Der Doelen BF, Van Den Bekerom MP, Dekker R, Van Dijk CN, Krips R, Loogman MC, Ridderikhof ML, Smithuis FF. Diagnosis, treatment and prevention of ankle sprains: update of an evidence-based clinical guideline. British journal of sports medicine. 2018 Aug 1;52(15):956-.

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