Ankle Sprain and Rolled Ankle Treatment in Burlington, ON
Quite often we hear of patients who repeatedly sprain their ankles. Weeks, months or even years may pass between episodes, but there is a definite pattern of inversion ankle sprain (or “rolling your ankle”) on a specific side. Often times this can be attributed to what we call a functional ankle instability.
Rolled Ankle – What is it?
Quite often, patients tell us they keep “rolling their ankles”. In this case, they more than likely have functional ankle instability. With functional ankle instability, our body controls the muscles around the affected joint in an altered fashion due to repeated episodes of injury. So what can we do to fix this?
How Common Are Ankle Sprains?
Ankle sprains are one of the most common injuries we see, accounting for an estimated 25 to 50% of all sports injuries. The inversion sprain, where you step on the outer edge of the foot and “go over” on the ankle, makes up the large majority of them and damages the ligaments on the outside of the ankle. They show up a lot in field sports like soccer, but you do not have to be an athlete to roll an ankle stepping off a curb. A lesser-known and often more stubborn version is the high ankle sprain, which involves the ligaments above the joint and tends to take longer to settle.
Why Do Ankle Sprains Keep Happening?
A big part of the answer is proprioception. That is the sense that lets you feel where your joints are without looking at them. When you sprain an ankle, you stretch and damage the ligaments and the small position sensors inside them, and that feedback loop gets disrupted. The ankle is then a little slower to react the next time you land awkwardly, which is why one sprain so often leads to another. Retraining that sense is one of the most useful things you can do to break the cycle.
Physiotherapy for Ankle Sprains
The specific approach a physiotherapist or chiropractor might use to treat an ankle sprain can vary. Oftentimes, it depends on the stage of the injury. To combat chronic, repeated ankle sprains it is essential to retrain and strengthen certain muscles and movement patterns in the ankle. This is not appropriate immediately after an acute ankle sprain, however. In the case of a swollen, recent ankle sprain the treatment approach is different.
Treatment for Acute Ankle Sprains
The physiotherapists in our Burlington sports injury clinic often use a combination of laser therapy and acupuncture in the initial stages of ankle sprain recovery. Laser therapy has a reputation for reducing swelling and eliminating pain quickly. For further information about laser therapy, please visit our laser page.
Active Release for Ankle Sprains
In our Burlington clinic, Active Release Technique is performed by our chiropractors. Active release has a great reputation for assisting with tissue mechanics in chronic ankle sprains. Again, if you just sprained your ankle it is not likely to be appropriate. In the later stages of healing, it may be more helpful.
Graston Technique for Ankle Sprains
The Graston Technique is another technique that can be helpful for ankle sprains. Similar to active release, Graston is more appropriate in the later stages of healing. It assists in the breakdown of dysfunctional scar tissue that occurs as a result of the initial injury. Again, in the early stages of recovery from an ankle sprain, a treatment like laser therapy is more beneficial.
Balance and Proprioception Training
Once the acute swelling has settled, retraining your balance is where a lot of the long-term progress is made. The research on balance training for preventing future sprains is mixed, but there is little downside to it, so we often build it into a recovery plan for patients who keep rolling the same ankle. The idea is to gradually challenge the ankle’s position sense until it can react quickly again. A simple progression we use looks like this:
- Stand on one foot.
- Stand on one foot and trace a star pattern around you with your free foot.
- Stand on one foot with your eyes closed.
- Stand on one foot with eyes open while bouncing a ball off a wall.
- Progress to an unstable surface like a wobble board or BOSU.
Keep in mind that ankle instability is a complex issue. Things like previous injury, footwear, bracing or taping, and how quickly the muscles around the ankle react can all matter, so the right mix is worth sorting out with a practitioner rather than guessing.
Exercises for Ankle Sprains
According to some recent research, the peroneus longus muscle has been found to be dysfunctional in many patients who have experienced repeated ankle sprains. Although the specific cause is unknown, this altered muscular activity can be expected to reduce protection against ankle sprain. Consulting with one of our practitioners is recommended to assist you in finding the appropriate management strategy for your ankle sprain. For more information about our Chiropractors, please visit our Chiropractic Page. For information about our Physiotherapist, please visit our Physiotherapy page. Burlington Sports Therapy – 905.220.7858 info@burlingtonsportstherapy.com
References
Santilli V, Frascarelli MA, Paoloni M. Peroneus longus muscle activation pattern during gait cycle in athletes affected by functional ankle instability. The Journal of American Sports Medicine 2005; 33(8): 1183-1187.
Ergen E, Ulkar B. Proprioception and ankle injuries in soccer. Clinics in Sports Medicine 2008; 27: 195-217.
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