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Sprained ankle
What is a sprained ankle?
Sprained ankle is a very common injury. It normally happens when you stretch the ankle ligaments by walking on an uneven surface, or accidentally twisting your foot beyond its normal range of movement. Symptoms of a sprained ankle include pain, swelling and bruising.
There are three different grades of injury:
- Grade 1 is a mild sprain
- Grade 2 is a partial tear of the ligament
- Grade 3 is a severe sprain and involves a complete tear of the ligament
The treatment for each grade is different.
How do we treat sprained ankles at the Mansfield Clinic?
As always, the diagnosis is key. Dr Allfree will give you a thorough examination to determine which grade of ankle sprain you have. If you have a Grade 3 injury, you may require hospital treatment, and appropriate referral can be organised. Grades 1 and 2 injuries will be treated at the Mansfield Clinic with simple anti-inflammatory measures, manual therapy such as osteopathy to keep your ankle moving and prevent stiffness, and an appropriate exercise programme. Sometimes it may be necessary to use localised cortisone injections around the area of injury.
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Causes of a sprained ankle
A sprained ankle usually happens when the foot twists inwards. This can make the ligaments on the outside of the ankle stretch past their normal range. This is known as an inversion injury.
A sprained ankle may be caused by a number of different things, such as:
- walking on an uneven surface
- a sudden change in direction while playing sport
- landing awkwardly from a jump
It is more common to sprain your ankle if it has been sprained previously. This is because the ligaments become weaker, leaving your ankle unstable.
Diagnosis of a sprained ankle
Dr Allfree will ask about your symptoms and give your ankle a thorough examination. He will also ask you about your medical history and exactly how you injured your ankle. He will check for pain, swelling and bruising around the ankle. He will want to see how much you can move your ankle and whether you can put any weight on your foot. You may need an x-ray, if you can’t put weight on your foot, or there is any possibility of a fracture.
Treatment of a sprained ankle
It is important that you begin to treat your sprained ankle as soon as possible. This may help to speed up your recovery, and prevent the ankle from being permanently unstable.
Self-help
In the first 48 to 72 hours after your injury, it’s important to follow the RICE regime:
- Rest your ankle for the first two to three days, and then re-introduce movement so you don’t lose too much muscle strength.
- Ice the injured area using an ice pack to reduce swelling and bruising. Don’t apply ice directly to your skin. Purpose-made ice packs can be purchased from the Mansfield Clinic.
- Compress your ankle by bandaging it. This will help to support your sprained ankle and reduce swelling. The bandage should not be too tight, and you should remove it before going to sleep.
- Elevate your sprained ankle above the level of your heart to control swelling. Try to keep it elevated as much as possible until the swelling goes down.
For the first 72 hours after your injury, there are certain things you should not do. These can be remembered using HARM:
- Heat. Heat encourages blood to flow to the area, which is the opposite effect of using ice.
- Alcohol. This can slow down the heeling process by increasing bleeding and swelling.
- Running.
- Massage. This can increase bleeding and swelling.
Medicines
Over-the-counter painkillers, such as paracetamol, can be used to help relieve the pain of your sprained ankle. 48 hours after your injury, Dr Allfree may also suggest you use ibuprofen to help reduce swelling around your sprained ankle.
Exercise
As you feel that your pain is tolerable, start doing some gentle exercises. These may help prevent stiffness and will get your ankle moving again.
Osteopathy
If your sprained ankle is more severe, you may need manual therapy, such as osteopathy. This aims to keep your ankle moving, prevent stiffness, and strengthen the muscles around your ankle. You may be asked to focus on building your strength and mobility through co-ordination exercises and balance training. Dr Allfree is a medically qualified osteopath, and he will be able to give you the appropriate treatment and exercise regime.
Injection therapy
Sometimes ankle injuries may not respond completely to manual therapy. In these cases, localised injections of steroid and local anaesthetic may be beneficial. Dr Allfree has had a lot of experience in the administration of steroid injections for soft tissue injuries.
Surgery
If your ankle is still causing you pain and is not responding to treatment, Dr Allfree may suggest referral to an orthopaedic surgeon, and he will be able to make the necessary arrangements.
Prevention of a sprained ankle
It’s impossible to totally remove the likelihood of spraining your ankle but there are some things you can do to help prevent the recurrence of a sprained ankle. The most important thing you can do is to maintain the strength and flexibility of the muscles surrounding your ankle. Here are some more self-help measures:
- Wear shoes that fit and are appropriate for the activity you’re doing.
- keep your weight under control.
- Take extra care when walking or running on uneven surfaces.
- Warm up and stretch your muscles properly before playing sport.
- When playing sport, ensure that you wear suitable protective clothing.
- Do some simple stretching exercises every day.
- Do not play sports or exercise when you are overtired.