Ankle Sprain Advice Sheet

This type of injury is very common in contact sports. The ligaments are sprained due to sudden stretching. This typically occurs when the ankle is suddenly "twisted"

Signs & Symptoms:

Pain, especially when you bear weight on the affected foot

Swelling and, sometimes, bruising

Restricted range of motion

Some people hear or feel a "pop" at the time of injury.

Useful Tip:

Doctors normally use a set of guidelines in deciding if you require an x-ray or not. These guidelines are called the ‘Ottawa Ankle Rules’ If you have bone tenderness along thedistal6cm of theposterioredge of thetibiaor tip of themedial malleolus, or bone tenderness along the distal 6cm of the posterior edge of thefibulaor tip of thelateral malleolus, or an inability to bear weight both immediately and in the A&E department for four steps.

Aims of rehabilitation:

Control pain and swelling.

Maintain and improve both mobility and flexibility.

Restore Proprioception

Restore muscle strength.

Return to full fitness.

Reducing pain and swelling:

Protect, Rest, Ice, Compress and Elevate (P.R.I.C.E.) immediately.

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‘See GBUK-KRFC Immediate Post Injury Management Sheet’

Improving mobility and flexibility:

Gentle ankle movements if it is not painful - repeat 1min, 5 times daily. This may be started after the initial acute stage - usually 48 hours.

Progressive Weight Bearing as pain allows – pool walking, walking, static bike

Ankle Stretches - hold for 30 secs, 4reps, repeat 4 times daily. This may be started after the initial acute stage - usually 48-72 hours.

Retrograde Massage – 5-10mins, 2 times daily. This may be started after the initial acute stage - usually 48-72 hours.

After the acute stage apply gentle sports massage techniques. For a grade two or three contusion, sports massage should be avoided until the acute stage is complete.

Restoring proprioception:

It is important that you restore your ability to stabilise the ankle through balance exercises. This may be started after the initial acute stage - usually 48-72 hours

Stepping onto 1 foot and holding your balance ensuring you maintain good overall body position. You can make it more difficult by stepping onto an uneven surface. 5mins, repeat 3 times daily

Restoring muscle strength:

For a grade I sprain, strengthening exercises may be performed as soon as they can be done without pain. Start with the easier exercises on a daily basis and progress as soon as you feel comfortable onto the more difficult exercises which should be done three times a week.

For a grade II sprain, it may be a week before strengthening is possible and a grade III even longer.

All strengthening sessions should start with a gentle warm up and stretch and finish with a good stretch. Strengthening should continue for weeks after you feel the injury has healed.

If the athlete is unable to continue with normal training, then swimming or cycling can be done instead, or if this is not possible work on the upper body strength. It is important to continue a training routine of some description.

The above guidance only covers the early part of your rehab and maybe amended according to the type of injury you have’

‘If in doubt stop and seek a healthcare professional’s advice’

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Please call 07794 269070 and ask for Graham