It's Not Just an Ankle Sprain!
Ankle sprains can range from being a nuisance to becoming a serious and recurrent problem. The most common sprain is referred to in physical therapy as an inversion sprain, where the bottom of the foot is forced inward, creating tension stress to the outer ankle.
Grading the Seriousness of Ankle Sprains
Sprains are graded by physicians depending on the extent of injury to any one of the three major ligaments that support the outer aspect of the ankle.
- A grade one sprain does not compromise the integrity of the ligament, but can be very painful.
- A grade two sprain has minimal tearing with some stretching of the ligament.
- A grade three sprain involves a tear to the ligament and an inability of the ligament to function.
All three grades of ankle sprains can be very painful and have consequences regarding future activity.
Diagnosing Ankle Sprains
If you injure your ankle, an X-Ray is often performed on your ankle to rule out the possibility of a fracture. If a fracture is identified, immediate immobilization with a cast or splint is required.
If there is no fracture, patients are often referred for physical therapy and rehabilitation is provided. The physical therapist will perform an assessment and identify appropriate interventions.
Initial Treatment of Ankle Sprains
For an acute ankle sprain, therapeutic modalities, such as ultrasound (electronic stimulation) and tissue mobilization, are provided soon after the injury. Additionally, rest, ice, compression wraps and elevation—also knows as "R-I-C-E"—is a good rule of thumb early in the post injury phase.
Once the swelling and pain is reduced, and the injured ankle tolerates minimal weight-bearing activity, the next phase of physical therapy begins.
Additional Treatment of Ankle Sprains
During the next stage of ankle injury treatment, the physical therapist will initiate gentle strengthening and proprioception activities. Proprioception is the ability to identify the body's orientation in space. Ligaments, in addition to providing stability, have a dual role in that they also give feedback to the brain, identifying the position of a joint or limb. When a sprain occurs, this ability is significantly affected and the potential for re-spraining the ankle is increased.
The physical therapy treatment for this is to repetitively have the joint move through all the motions, initially with no weight bearing and increasing the weight on the ankle as tolerated.
When strength and proprioception have increased, gradual return to normal exercise is allowed.
Getting Help for an Ankle Sprain or Ankle Injury
As with any acute injury, an ankle sprain should be assessed by your primary care physician. If appropriate, obtain a referral for physical therapy and rehabilitation, and call Bernier Physical Therapy Associates in Newburyport, Mass. Our experienced staff will help you with your recovery. We are available for a free 15-minute consultation, by appointment, over the phone or in person.
Additional Resources and Articles
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