Ankle Sprain – Rehabilitation guideline

Ankle sprains are the most common type of ankle injury and can account for up to 20% of all sporting injuries. Poor rehabilitation may lead to recurrent sprains, persistent disability and impairment of athletic performance.

An ankle sprain occurs when the foot rolls outwards, causing over-stretching or tearing of the ligaments located on the outside of the ankle.

Ankle sprains: 3 grade classification

Ankle sprains can be classified into 3 different grades depending on the severity of damage:

Grade 1 – mild, painful, minimal tearing of the ligament fibres;

Grade 2 – moderate, painful, significant tearing of the ligament fibres;

Grade 3 – severe, sometimes not painful, complete rupture of the fibres.

Rehabilitation guideline

In the initial stages, implementing the POLICE principle is recommended to promote safe and effective loading. This will help manage the effects of inflammation, facilitate healing and minimise the risk of further injury.

Following this, you should seek advice from a physiotherapist as soon as possible. Physiotherapists are highly trained health professionals who specialise in the assessment, diagnosis and management of ankle injuries.

Your physiotherapist will ask you questions regarding your injury and the symptoms you are experiencing. A thorough assessment will be conducted to diagnose your injury and determine the extent of damage. An accurate diagnosis is critical in ensuring appropriate management and to rule out any other pathology e.g. a fracture.

An individualised rehabilitation program will then be developed which can be summarised into three different phases. The initial phase is aimed at swelling and pain management, which may involve icing, taping, bracing, crutches or a moon boot depending on the severity.

The second phase will focus on normalising your gait, restoring mobility and begin to incorporate exercises aimed at improving your lower limb strength and balance.

Lastly, the final phase will continue to build on your strength and balance, whilst incorporating more goal-oriented or sport specific tasks once adequate function has been regained.

Extensive research has shown that individuals who adhere to a rehabilitation program were significant less likely to experience recurrent ankle sprains. However, while the risk of re-injury can be reduced, it is important to remember that unfortunately accidents can still happen.

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