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So you are on your way to do your Christmas shopping or off out to do your favourite activity and boof your ankle has bent in an uncompromising way. The initial feeling is a little bit of shock and then an intense skin crawling feeling like you have just had your ankle smashed to pieces by a sledge hammer.
It hurts, I know the feeling, it and has happened to me on more than one occasion. I still remember vividly my first ankle sprain. I was on the school football field, I went to kick a ball and somehow just stomped on it and then my ankle turned inward where I may of shed a little tear but i'd never admit that of course.
Over the years I have had probably eight ankle sprains, some from literally walking down the street and others from hiking or playing some kind of sport. Statistics show if you have had one ankle sprain then there is a 70% chance of spraining the same ankle again, OuCh!
What happens when you have an ankle sprain?
There are three main things, either the ligaments that hold the ankle and it's many joints together are over stretched or torn. There are three grades.
1. Grade 1: Over stretched
2. Grade 2: Partial tear
3. Grade 3: Complete tear/rupture
The next phase is pain, the pain generally, is instant but like any injury it can take 74 hours before the full extent of the injury is felt. Soon after the insult from that sledge is inflammation and swelling. Our body is a healing machine so the brain wants to protect you. It does this by sending inflammatory chemicals to the site of injury and swells it up to make the ankle immobile. Sometimes internal bleeding occurs which causes the beautiful rainbow coloured effect around the ankle.
What can you do for an ankle sprain?
First is to P.R.I.C.E
PROTECT: To gingerly take the weight off and have a rest and be in a place where there is less chance of injuring further
REST: Rest is important but we also need to challenge ourselves to keep some motion in the joint. A serious rupture needs medical intervention so if concerned see a specialist or get an ultrasound or MRI. Gentle movement with sprains in general has showed to increase recovery times
ICE: Never used heat as it will increase blood flow and increase swelling. It is debated whether ice should even be used as it interferes with the healing process. Ice will reduce some inflammation and a little pain relief also. Always wrap the ice in a thin tea towel to avoid an ice burn. 20 minutes at a time and reapply every hour on the first day.
COMPRESSION: A bandage can help but I have found sports tape to be superior, we are not sure why but it can help dramatically with the ankle swelling. It should not be tight or restricting but should create a comfortable brace.
ELEVATE: By elevating the foot above the heart, elevation reduces the amount of swelling. This can be done for 24 hours in a moderate sprain but may need to be longer for more serious sprains.
How long until it's better?
It does vary, most tissue in the body heal in around six weeks, depending on the self care. Some people recover with no problems and for other is can turn chronic.
What can Chiropractic do for ankle sprains?
Many things! Thing acupuncture to help with pain, joint mobilisations as often some of the joints are restricted and even get stuck where the joint mechanics become inefficient. Deep tissue work to help healing, sports taping and of course rehab.
Why Rehab?
The ligaments in the ankle have specialised receptors called mechanoreceptors. There are four types and they work together by sensing where we are in space and time, pressure and joint position. When the ligaments are damaged from an ankle sprain so are these mechanoreceptors. This is where rehab comes in, so to avoid further ankle sprains in the future.
We prescribe single leg stands progressing to doing these single leg stances with the eyes shut to retrain the ankle and to make it stronger and more versatile. There are also many other exercises to help strengthen and create better awareness.
I see ankle sprains in my office every week, some take time and others heal within a few sessions. I see many runner from Cardiff and nothing feels better than getting these people back to doing the things that they love.
So if you have recurring sprains or an acute one you know who to call
Matthew Corbin MChiro D.C