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HOW DO ANKLE SPRAINS OCCUR?
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The
ankle joint has many ligaments that provide stability
by limiting the amount of side-to-side movement |
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Ankle
sprains are usually caused by an excessive rolling of
the foot onto its outer edge so that the sole of the foot
is turned inwards. This causes the ligaments on the outer
side to overstretch and tear |
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Individuals with a history of a previous ankle sprain are more likely to have repeated ankle sprains than individuals who have not injured it before. |
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WHAT SHOULD YOU DO IF AN ANKLE SPRAIN
OCCURS?
• Apply the RICED procedure...
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RICED
procedure
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REST
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Rest
reduces further damage
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Avoid
as much movement as possible to limit further injury
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Don't
put any weight through the injured part of the body.
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ICE
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Ice
cools the tissue and reduces pain, swelling and bleeding
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Place
ice wrapped in a towel onto the injured area
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Apply
ice immediately for 20 minutes, then for 20 minutes
every two hours for the first 48 hours.
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COMPRESSION
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Compression
helps to reduce bleeding and swelling
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Hold
the ice pack firmly in place with a bandage
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Between
ice treatments maintain bandage compression.
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ELEVATION
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Elevate
the injured area to reduce bleeding and swelling
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Place
the injured area on a pillow for comfort and support.
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DIAGNOSIS
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If
the injury has not improved significantly within 48
hours, have the player assessed by a medical professional
(e.g. a doctor or physiotherapist)
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An
accurate diagnosis is essential for proper rehabilitation
of moderate to severe injuries.
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ALWAYS seek the advice of a medical professional for an accurate diagnosis.
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WHAT REHABILITATION SHOULD FOLLOW AN
ANKLE SPRAIN?
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The
following recommendations serve as a guideline only.
Always seek the advice of a medical professional for
a rehabilitation program specific to you and your injury.
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Range of motion
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Restoring
normal range of motion will allow proper function of the ankle.
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Pointing
and flexing the foot, or tracing letters with the foot are good
ways of improving range of motion following an ankle sprain. |
Cardiovascular
fitness
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Keeping fit, although difficult when injured, will ensure peak performance and a lower risk of re-injury upon return to sport |
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Try to find different types of exercise that will maintain fitness without making the injury worse |
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Swimming
is recommended early in ankle sprain rehabilitation. As healing
improves, pain-free cycling and walking can also be included. |
Strength
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Regaining
strength in the injured ankle will help to stabilize the ankle
joint |
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Return
to play is usually considered safe when 90% of pre-injury strength
or 90% of the opposite ankle's strength (assuming that ankle
is injury free) is achieved |
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Strength
can be assessed by this simple home exercise. While bearing
weight on both feet, assess how well you can:
• Walk on your toes (tests
calf muscles)
• Walk on your heels
(tests calf and shin muscles)
• Walk on the outside
edge of your feet (tests inversion muscles)
• Walk on the inside
edge of your feet (tests eversion muscles). |
Proprioception
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Proprioception
is the awareness of one's own body position and is important
in balance |
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Proprioception
exercises help to re-educate the ankle so that it can be protected
against future sprains. Wobbleboard exercises and balancing
tasks are good examples. Try the exercises with your eyes closed
to really test your proprioception |
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External
supports such as braces and taping may also improve proprioception
by stimulating the skin receptors about the ankle joint. |
Psychological
status
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Reduced confidence following an ankle sprain may prevent an athlete
from attempting movements that will assist in recovery (e.g. running
on uneven surfaces, sudden changes of direction and jumps) |
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Gradually attempting more difficult agility tasks and setting realistic goals and timeframes may help to rebuild sporting confidence |
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Return
to competition is not advised until an individual has 100% confidence
in their playing ability. |
Sport-specific
rehabilitation
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When general
function has been restored, rehabilitation should focus on preparing
the ankle for sport-specific activity (e.g. jumping, landing,
cutting or simply combining different elements such as run,
step off the right foot, step off the left) |
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As progress
allows, the intensity should be increased (e.g. running at 1/2
speed to 3/4 speed to full speed) and other elements of the
sport should be included (e.g. adding a ball skill or performing
sequences i.e. run, step off the right foot, pass, step off
the left foot, pass etc). |
Ensure you are completely rehabilitated before returning to competition to minimise the risk of re-injury.
REHABILITATION GUIDELINES FOR A GRADE
1 ANKLE SPRAIN
(mild to moderate sprain)
| NOTE: This is an approximate guide only. Timeframes for rehabilitation and return to play may vary depending on the nature and severity of the injury. Always seek the advice
of a medical professional for a rehabilitation program
specific to you and your injury. |
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POST-INJURY
Have swelling and pain
settled? |
YES
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| If still unable to weight-bear consult a medical professional for further treatment |
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| BEGIN
RANGE OF MOTION EXERCISES |
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Point
and flex foot |
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Partial
weight-bearing |
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CAN YOU
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Move
your ankle without pain? |
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YES
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| CONTINUE
TO IMPROVE RANGE OF MOTION AND WALKING |
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| BEGIN
STRENGTH EXERCISES |
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Point
and flex foot against resistance |
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Move
foot side to side against resistance |
| BEGIN
PROPRIOCEPTION EXERCISES |
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Balance
on one leg |
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Wobbleboard |
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MAINTAIN
FITNESS
Stationary cycling, upper body exercises |
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CAN YOU
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Balance
on injured foot for an equal amount of time as the
other foot? |
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Point
and raise up on your toes in equal amounts as the
other foot? |
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Walk
on your tip toes? |
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Walk
on your heels? |
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Walk on the inside edge of your feet? |
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Move without pain? |
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YES
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| CONTINUE
TO IMPROVE STRENGTH AND MOVEMENT |
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| BEGIN
FUNCTIONAL EXERCISES |
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Jumping,
hopping, twisting, figure of eight running |
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MAINTAIN
FITNESS
Jogging if comfort permits, stationary cycling |
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CAN YOU
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Run forwards and backwards? |
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Slow down and stop suddenly? |
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Jump and hop? |
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Run up and down hills? |
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Cut to the left and right at speed? |
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Complete all exercises with 100% confidence? |
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YES
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| CONTINUE
TO IMPROVE AGILITY AND SPORT-SPECIFIC SKILLS |
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MAINTAIN
Fitness, Range of motion, strength, proprioception |
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ALWAYS seek the advice of a medical professional before returning to sport. Inadequate rehabilitation and a premature return to sport will increase the risk of re-injury.
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Continue
stretching, proprioception and strengthening exercises
as part of a normal training routine |
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Taping,
bracing or wearing high-top shoes following adequate rehabilitation
will provide added protection to the ankle |
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If
there is a history of repeated ankle injury, wear an external
ankle support |
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In
sports where cleated shoes/boots are worn (e.g. cricket,
rugby and soccer) a change in footwear design may reduce
the risk of re-injury |
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Stay
conditioned for the physical demands of the sport
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If ankle sprains continue to occur, consult a medical professional for advice on other possible contributing factors.
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