Ankle Sprain Recovery

Response Physio | 08.09.23

Ankle Sprain Recovery
Effective Physiotherapy Techniques and Tips for a Speedy Return to Full Mobility

The ankle is relatively complicated consisting of three different joints, and a huge array of muscles, tendons and ligaments. Ankle injuries are common and varieties of ankle sprains are often seen in practice. The role of ligaments is to contribute to stabilising joints, and a ligament sprain occurs when something happens to the ligament that exceeds its current tolerance. For example, tripping over or a sudden change of direction and deceleration may overstretch one or more ligaments, the most common at the ankle being the Anterior Talo-Fibular Ligament (ATFL) and Calcaneofibular Ligament (CFL).

A ligament sprain can often be graded into 1,2 and 3 where a 3 is a complete rupture and can sometimes require surgery if the client and consultant wish. There is no one-size-fits-all approach to ankle recovery with timelines only acting as a guide, the progression of rehab will be dictated by presentation in the clinic.

There is often an argument for the ‘hands on’ vs. ‘hands off’ approach in rehab meaning how much work the therapist does in regards to soft tissue work, mobilisation etc. vs. exercises. For an ankle sprain no matter how many hours are spent on ‘hands-on’ treatment it cannot repair the ligament at a faster rate and make the ankle stronger. This is why it is imperative to find a therapist that encourages the client to perform extensive rehab away from the clinic as this is where the quickest progression route will be made.

Many different new and old protocols can be followed with the most up-to-date being PEACE and LOVE. Protection, elevation, avoiding anti-inflammatories, compression, education, and load, optimism, vascularisation, exercise. A client will be guided through this in a variety of ways by their therapist. Depending on the severity of the sprain, the initial few days will focus on calming symptoms and letting the body’s natural healing process start, this is where the PEACE takes place. Ice may be used as a pain relief but it is not recommended to use it all the time as it may delay healing. Soon after, the LOAD phase can begin with movement and ankle mobility being the next focus whilst some low-level isometric strength work may be included. As these progress, further ankle strengthening exercises through range will be implemented as well as stability and proprioception work.

At this stage there may be very limited pain however pain and tissue damage do not always correlate so to avoid re-injury it is important to continue with rehab and return to activity/sport training. The therapist will work out the individual needs analysis of the client and will ensure to bridge the gap between basic rehab and sport. This will include plyometric, agility and sport-specific scenarios. There will then be a collaborative decision between the client and therapist considering all factors as well as psychological to whether the client can be discharged. It is important to note during the whole process there will be an element of maintaining fitness with the uninjured aspects of the body, this may include upper body strength work, whole leg work on the uninjured side, knee and hip work on the injured side and aerobic work on a hand bike.

If a client has not suffered from an ankle ligament injury but is active and plays a sport where there is a higher risk, there are some preventative measures that may be helpful. As other blogs have stated, balancing the frequency/intensity/volume of training with adequate recovery is imperative. Single-leg lower limb strength and stability will increase resilience. Appropriate footwear for the task is also important to provide some external support where needed. It is important to note that it is impossible to fully prevent an injury but the above tips would certainly reduce the risk of an ankle ligament sprain.

If you have suffered an ankle injury, would like some advice or have any questions, please do not hesitate to get in touch and book an appointment.

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