The sprained ankle
Diagnosis
During an assessment, your physiotherapist will examine your ankle, foot and lower leg. The therapist will touch the skin around the injury to check for points of tenderness and move your foot to check the range of motion and to understand what positions cause discomfort or pain.
If the injury is severe, your therapist may refer on for one or both of the following scans to rule out a fracture, or to further assess the damage to your ligaments or tendons.
X-ray
During an X-ray, a small amount of radiation passes through your body to produce images of the bones of the ankle. This test is good for ruling out fractures, but it can be limited in its results if you have a large amount of swelling
Ultrasound
An ultrasound scan uses sound waves to produce real-time images. These images may help your therapist judge the condition of a ligament or tendon when the foot is in different positions, and assess the likelihood of needing a moonboot.
Treatment
Treatment for a sprained ankle depends on the severity of your injury. The treatment goals are to reduce pain and swelling, promote healing of the ligament, and restore function of the ankle. For severe injuries, you may be referred to an orthopaedic specialist or a sports physician for further investigations.
Self-care
For self-care of an ankle sprain, use the R.I.C.E. approach for the first two or three days:
Rest. Avoid activities that cause pain, swelling or discomfort. Try and keep the weight off your foot.
Ice. Use an ice pack or ice bath immediately for 15 to 20 minutes and repeat every two to three hours while you're awake. If you have vascular disease, diabetes or decreased sensation, talk with your doctor before applying ice.
Compression. To help stop swelling, compress the ankle with an elastic bandage until the swelling stops (you can even use tight fitting socks if needed). Don't hinder circulation by wrapping too tightly.
Elevation. To reduce swelling, elevate your ankle above the level of your heart, especially at night. Gravity helps reduce swelling by draining excess fluid.
Physiotherapy
Once the swelling and pain has reduced from its initial stages, you can start to think about seeing your physiotherapist. Your physiotherapist will ask you to begin a series of exercises to restore your ankle's range of motion, strength, flexibility and stability. They'll also help with further reducing the swelling and pain.
Balance and stability training is particularly important to retrain the ankle muscles to work together to support the joint and to help prevent recurrent sprains. These exercises may involve various degrees of balance challenges, such as standing on one leg, using a wobble board, or undertaking some hopping exercises.
If you sprained your ankle while exercising or participating in a sport, talk to your physiotherapist about when you can resume training or your activity. Your physiotherapist will want you to perform particular functional tests and movements to determine how well your ankle functions for the sports you play.