Ankle sprains can happen easily and, while they are not often serious, they can be painful and take a while to mend. Physiotherapist Nina James explains all you need to know about ankle sprains and how to treat them.
What is an ankle sprain?
An ankle sprain is one of the most common musculoskeletal injuries – more specifically a lateral ankle sprain (a sprain to the outside ligaments of the foot) – and is a stretch or a tear, either partial or full, of the ankle ligaments. This often happens when the ankle moves past its normal range of motion, for example hiking over difficult terrain or being involved in a sporting incident.
What is the difference between a sprain and a strain?
An ankle sprain is where the ligament (a fibrous connective tissue that connects bone to bone) is stretched or torn, i.e by rolling the ankle over itself, usually affecting multiple parts of the ankle.
Whereas a strain, otherwise known as a pulled muscle, is where there is damage to the muscle tissue leading to a tear. This can occur for multiple reasons, more often than not from an overstretch or overuse of the muscle. Placing a foot on the uneven ground is a common cause of strains.
Ankle sprain symptoms
- Pain, especially when putting weight on the affected foot and/or when touching.
- Swelling and bruising that can be blue and black in colour
- Heat and redness over the area
- A lack of strength and movement around the foot and ankle
- Sometimes you may also experience tingling, numbness or pins and needles in the affected area
How long do sprained ankles take to heal?
Normally sprains take between 5–14 days to heal, however, if you have had a chronic sprain or recurrent sprains, it can take 3-12 weeks to recover, sometimes longer.
What to do immediately after spraining your ankle
If help is not near by, follow PRICE protocol (more details below). Elevate and compress if there is no ice available. If you have a first aid kit available, apply pressure by bandaging around the affected area in a figure of eight (this should not worsen your symptoms).
There is now evidence to suggest non-steroidal anti-inflammatory drugs may help with initial swelling and pain. However, this may affect healing time, so it is suggested not to take anti-inflammatory drugs. You should always consult a medical doctor who can advise further.
Ankle sprain treatment
In the first 72 hours you can use the following PRICE protocol to help.
P: Protect – through the use of crutches to offload the joint
R: Rest
I: Ice for at least 15 minutes to reduce swelling and pain
C: Compression – using a bandage or a brace to help to stabilise the joint
E: Elevating the ankle can help reduce swelling.
First-time ankle sprains tend to heal fairly quickly, however, without good rehabilitation you may be at a 70% greater risk of re-injuring your ankle at a later date.
If you have any concerns at all or your ankle doesn't appear to be healing, a physiotherapist can help.
In the first four weeks of injury a physiotherapist will first assess and diagnose your ankle, then assist with reducing swelling, decreasing pain and the risk of further injury. As the injury extends past the four-week acute stage and into the chronic stage, physiotherapists will focus on improving functional movement and stability of the joint.
Sprained ankle healing phases
Inflammatory phase, immediately after injury lasting 2-7 days.
Massage and drainage techniques can be used to reduce swelling and pain in the ankle. Taping can also be provided to improve stability in the ankle joint to prevent risk of any further injury.
Proliferative phase, lasting 4-6 weeks after inflammation.
A physiotherapist can help rehabilitation with a set of physical and manual techniques and exercises of the ankle to improve weight bearing capacity on the affected side and increase the range of motion, as well as retrieve ankle function whilst protecting the joint from a recurring injury.
Remodelling and maturation phase: this lasts for a longer period of time and is the final phase of healing.
This is where a physiotherapist will set specific long and short term goals to achieve alongside your rehabilitation, whether that involves the needs of your active daily living, returning to a sport, or even starting a new physical activity or hobby.
This will involve improving stability of the ankle, strengthening of the muscle, improving range of motion and mobility with exercises personalised to you.
You should always seek medical advice from a doctor or chartered physiotherapist for any injury or health concern
Nina James is a rehab physio at Six Physio Kensington