ANKLE SPRAIN: TREATMENT

Ankle sprain is one of the most common injuries in contact sports or that involve jumps like basketball or soccer. The ligament injuries happen generally for an acute traumastism, rarely occur for overuse. An ankle sprain occurs when the strong ligaments that support the ankle stretch beyond their limits and tear when we do an inversion of our foot. 

Anatomy

The ankle has 3 ligaments in its external part: anterior talofibular, calcaneofibular, posterior talofibular. All of them can be injuried, but the common ligament affected is the first one in a 70% of the time because it is the most exposed to the stretch. 

 

Ligaments of the ankle

Classification of ligaments injuries

Grade I: Mild. It represents a microscopic injury without stretching of the ligament on a macroscopic level.

Grade II: Moderate. It has macroscopic stretching, but the ligament remains intact.

Grade III: Severe. It is a complete rupture of the ligament. 

Treatment

When a ligament is stretched or broke occurs a vessels constriction around 10-15 minutes followed by an inflammation caused by increased blood flow to the area in the next 48-72 hours. Furthermore due the immobilisation, our muscles lost strength and the nervous system miss proprioception though which we perceive the position and movement of our body, including our sense of equilibrium and balance. The next treatment will fix these symptoms and problems. 

Acute phase (first 48-72 hours)

R: Rest. Avoid any activity that may aggravate the injury.

I: Ice. Maintain the application of cold 20 minutes being able to repeat the operation 3 and 5 times a day allowing at least 2 hours between each one.

C: Compression. Elastic tape for to protect the injury.

E: Elevation. Purpose is to avoid inflammation. 

 

RICE

Range of movement (since 4º-7º day)

Two series of 10 repetitions 2 times per day.

Active: lie on your back do flexion dorsal, flexion plantar, inversion, eversion and alphabetic movements (1 minute). 

Active movements without weight

Isometric: sit down in a chair do flexion plantar with the other foot on, Inversion, eversion against a wall and thrusts towards the ground. 

Isometric movements without weight

  

Strength (since 15º day)

Two series of 10 repetitions 2 times per day.

Isometric: stand up do flexion plantar, Inversion, eversion and thrusts towards the ground

Active: lie on your back do all movements with a elastic band.

  

Active movements with elastic bands

Proprioception (since 4º week)

Four series of 30 seconds

Walk tiptoe, walk on heels, lame foot and jumps lame foot. You can complicate these exercises closing your eyes or stand up over a unstable surface.

  

Proprioception exercises

Final phase (since 6º week)

If you don´t fell pain and restrict of range of motion you can jogging and movements in zig-zag

Zig-zag movements