Ankle sprains are highly prevalent and the approach of treatment for most Australians is: I’ll go see my GP, I’ll get an x-ray to clear a fracture, I’ll go home and I’ll simply hope for the best. But the truth is, we often hear as physiotherapists “this is my second ankle injury in…” often less than twelve months OR “I have weak ankles, I roll them all the time”. This occurs simply because you did not take our ankle rehabilitation seriously enough.
You may wonder why your physiotherapist is so insistent on you completing your ankle rehab after a sprain. Latest research indicates that those with chronic ankle instability (which is simply the recurrence of ankle sprains) have:
- Diminished neuromuscular control
- Muscle weakness
- Impaired joint position sense
- Ongoing and recurrent ankle sprains
- Impaired performance during functional tasks
- Perceived difficulties with day-to-day activities or even sport related tasks.
Although the pathology is immensely complex and we cannot say that only one factor causes an ankle sprain, but it is often interplay of many factors that cause a re-occurrence and starting rehabilitation early can help minimize some of these above factors which end up compromising the ankle joint.
What will my rehab be?
Overviews of systematic reviews with meta-analysis indicate strong evidence for use of non-steroidal anti-inflammatory drugs (ask your pharmacist or GP) and early mobilisation in the acute phase.
Exercise and manual therapy techniques are also supported for pain, swelling and function with exercise therapy and bracing helping to prevent chronic ankle instability.
Rehabilitation is individualised to each person depending on level of injury, re-occurrence and also on sporting or day-to-day demands. As per the evidence, progressive and comprehensive rehabilitation can help to minimize the deficits. Rehabilitation may include:
- Neuromuscular rehab, strengthening and control
- Ankle proprioception and balance re-training
- A PNF program
- Home management techniques
- Sporting advise and a return to sport program
- Bracing/ankle support devices
- Manual physiotherapy techniques
Our best advise would be: do not simply ‘hope for the best.’ A lot of emerging research suggests that there is a high prevalence (some research suggesting 80%!!) of re-injury when an ankle sprain is not properly treated or rehabilitation not completed and the rate of re-injury is high. If you are experiencing recurrent sprains, it is advised that you start your physiotherapy rehabilitation and long term management plan.