The Dreaded Ankle Sprain
The spring sporting season is upon us. Fields and courts are jammed with children and adults enjoying different outdoor sports. With an increase in activity level there is often an increase in injuries. A very common injury suffered by athletes on fields and courts is a sprained ankle.

The most common ankle sprain is when it twists to the outside. On a playing field this usually occurs by landing from a jump on someone else’s foot or a ball, stepping in a divot or pothole or tripping while running. When an ankle is sprained, sometimes a “crack” will be heard or a “pop” will be felt. This doesn’t necessarily mean that the ankle is broken. A good self-test is the ability to bear weight. If the athlete is unable to bear weight on the injured ankle, an x-ray is a good idea to rule out a fracture.

Immediately after twisting an ankle, regardless of if it is a bad sprain or a mild sprain; use the R.I.C.E. principle (Rest, Ice, Compression and Elevation). 10 – 15 minutes of ice at a time can make a huge difference. Compression will help to manage the swelling. Elevation must be higher than your heart for it to do maximal good.

“When can I return to sport?” is the question immediately asked by most athletes after an ankle sprain. It depends on the severity of the injury. A badly sprained ankle can take 16 weeks or more to heal. Most mild sprains will take less than a week to heal. It depends on the amount of damage done to the ligaments and how many ligaments are involved.

After any sprain, regardless of the severity, certain exercises will help. If the sprain is very bad it may be weeks or even months before the person is able to do these exercises. For the vast majority of mild to moderate sprains, these exercises can be started right away.

Range of motion exercises help to keep the joint from getting too stiff. Performing circles clockwise and counterclockwise will help increase circulation and maintain range of motion. Drawing the alphabet in the air with the foot and toes will also encourage movement in every direction.

Balance re-training is essential after a sprained ankle. The joint receptors which help relay information to the brain about where the foot is in space are impaired after even an insignificant twist. If not properly retrained they will not come back automatically. This is why people re-sprain the same ankle time and time again. Simply by balancing on the sprained ankle and challenging your balance system, the balance reactions can come back. This greatly decreases the likelihood of spraining the ankle again.

Physiotherapy modalities such as ultrasound and electrical stimulation can help hasten the healing of a sprained ligament. Manual techniques such as frictions to the ligament can help influence the scar tissue as the ankle heals. Taping and bracing the ankle are other tools that help to manage the healing and can facilitate a quicker return to sport.