Did you just sprain your ankle? I did recently. It hurts! Ankle sprains occur so often that sometimes it can be easy to overlook helpful treatment strategies to accelerate the healing because, well, they will heal on their own, right?
Ankle sprains are the most common lower extremity injury in sport. The most common is an inversion sprain where the foot rolls under the inside portion of the ankle. There are eversion sprains and diastasis (aka "high ankle") sprains, but these are less common.
To x-ray or not to x-ray? That is the question.
The first question is always, "Do I need an x-ray?" Typically an x-ray is needed if a patient meets certain x-ray decision making criteria. For instance, the Ottawa Ankle Rules and other questions may help to determine whether an x-ray is necessary. Things like:
Severity or "grades" of ankle sprains.
Patients usually like to know the severity of an ankle sprain. This is understandable as it will help gauge the prognosis. The severity for most sprains ranges from mild, to moderate, to severe.
What treatment strategies can be used to accelerate the healing?
During an acute phase of injury, an old and still popular acronym for an ankle sprain, and nearly any injury, has been to R.I.C.E. This stands for Rest, Ice, Compression, and Elevation. Over the years, most injury and exercise specialists have moved away from this to recommend new acronyms like P.O.L.I.C.E. (Protection, Optimal Loading, Ice, Compression, and Elevation) or M.I.C.E. (Movement, Inflammation exonerated, Compression, and Elevation). While I do like to still compress and elevate an injury when swelling is persistent and severe, I'm not incredibly fond of using ice as this can delay healing. The acronym I use in my practice is M.O.V.E.
What about rehab? Rehab must start the same day of the injury. Even if small.
Ankle sprain rehab exercises:
1. Mobility exercises
2. Stability exercises
3. Strength exercises
Ankle sprains are common. It is important to seek treatment from a medical professional especially in moderate to severe cases or if symptoms are not improving. Ankle sprains do have a good prognosis as they often heal with the most commonly reported residual problem being ankle stiffness. A patient's overall health, including physical and mental, along with proper nutrition and supplementation will significantly impact recovery. It is important to regain mobility, stability, and strength in a rehab process early on. This will speed the healing along. Also, by incorporating a long-term strategy to strengthening the ankles, a patient can reduce the occurrence of ankle injuries and how long it takes to heal if an injury were to occur again.
Creighton DW, Shrier I, Shultz R, Meeuwisse WH, Matheson GO. Return-to-Play in Sport: A Decision-based Model. J. Sports Med. 2010;20:379-385.
Delahunt E, Bleakley CM, Bossard DS, et al. Clinical assessment of acute lateral ankle sprain injuries (ROAST): 2019 consensus statement and recommendations of the International Ankle Consortium. Br J Sports Med. 2018;52(20):1304–1310.
Khan K, Scott A. Mechanotherapy: how physical therapists’ prescription of exercise promotes tissue repair. J. Sports. Med. 2009;43:247-251. (Request with CPSBC or view UBC) DOI: 10.1136/bjsm.2008.054239
Mirkin G. Why Ice Delays Recovery. Dr. Gabe Mirkin on Health, Fitness and Nutrition blog. Updated October 13, 2016.
Recek C. Calf Pump Activity Influencing Venous Hemodynamics in the Lower Extremity. J. Angiol. 2013;22:023-030.
The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
TAGS: ankle sprain injury, ankle sprain rehab, lateral ankle sprains, lateral ankle injury, lateral ankle sprain rehab, inversion sprain
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Dr. Jared Wilson, DC, MS
Dr. Jared Wilson blogs about chiropractic health and other relevant health news. He is an expert in musculoskeletal injuries and functional rehab. He holds a Chiropractic Doctorate degree and a Masters degree in Exercise and Sports Science.