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Physiotherapy After Ankle Injuries

Have you ever sprained an ankle and been told to walk it off, it will get better, you don’t need treatment, you will be fine? Wrong! Without appropriate assessment and treatment, there is a high risk of reinjury due to premature return to play, or long term pain from chronic instability. It is important to seek physiotherapy to guide you through a rehabilitation program tailored to your specific injury, and to understand that even if the swelling and bruising has subsided, this does not mean your ankle has fully healed.

Ankle sprains are one of the most common types of sporting injuries, and many of us at some point in our life has suffered from one. Sprains occur when ligaments are overstretched during excessive movements of the ankle, such as when you roll your foot inwards or outwards.

Depending on your mechanism of injury, you may damage one or multiple ligaments of your ankle (listed below). Injuries to the muscles or tendons can also occur as well as fractures to the tibia or fibula. If a broken bone is suspected, physiotherapist’s can refer and/or guide you to the appropriate x-rays/scans.

Ligaments of the Ankle

- Anterior Talofibular Ligament (ATFL)

- Calcaneofibular ligament (CFL)

- Posterior talofibular ligament (PTFL)

- Anterior tibiotalar ligament

- Posterior tibiotalar ligament

- Tibiocalcaneal ligament

- Tibionavicular ligament

Grades of Sprains

Return to your usual activities and/or sport will vary depending on the degree of tear.

Each ligament is graded on a scale of 1-3 (3 being the most severe):

  1. Stretching and/or minor tearing of the ligaments. Symptoms include mild pain, swelling and stiffness. It is an estimated 3-4 week recovery period.

  2. Some tearing of ligament fibres. Associated with moderate/severe pain and difficulty walking; moderate swelling, stiffness, poor balance and potentially some bruising. This grade of injury takes approximately 6-10 weeks for full recovery.

  3. Complete tearing/rupture of the ligament. Commonly requires crutches initially due to severe pain and swelling. On ligament testing there is severe laxity and joint instability. Usually involves 10-12 weeks of recovery. May require surgery in severe cases.

Physiotherapist’s are highly trained in accessing what structures are injured and the severity of the sprain and can provide approximate times frames of recovery, taking into consideration if there are any associated muscular or tendon injuries.

Aims of Rehabilitation and Treatment

Depending on your injury, physiotherapists use a range of treatment techniques to reduce your pain levels and get you back on your feet as soon as possible.

- Manage swelling through massage and tubigrip (compression stocking)

- Gait re-education with or without the use of crutches

- Improve ankle range of movement (ROM) with joint mobilisations and stretches

- Increase ankle strength

- Improve proprioception (joint position sense) and balance

- Facilitate healing / reduce further damage by taping and/or ultrasound

- Advice on safe levels exercise / graduated retrn to normal activities

- Education on a suitable ankle brace

When returning to sport, it is critical your ligament/s have had sufficient time to heal and you have no underlying ankle ROM, strength or balance/proprioception deficits. If you are suffering with ongoing pain post ankle injury, it is likely your ankle needs retraining in one or more of these areas. There are multiple assessments and functional tests our physiotherapist’s perform to assess these measures. Results provide a guide for your treatment, exercise prescription and assists in the decision of your readiness to safely return to training and games.

For more information or to book an appointment with one of our Physiotherapist’s are Moreton All Body Care, please contact us on 07 3886 9470 (Narangba) or 07 3888 6699 (Burpengary).


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