Ankle Injuries

Ankle Pain is most often caused by a traumatic incident (i.e. rolled ankle, fractured bone, stress fracture). However it may occur without trauma (synovitis, tendonitis, immobility, neuroma, bursitis, plantar fascitiis, poor foot posture, muscle weakness or imbalance).
Ankle pain is usually caused from one of the following:

  • Ligament Sprain (Lateral, Medial, Radio-Ulnar, Retinaculum)
  • Nerve irritation (Peroneal nerve, Sural)
  • Boney degeneration (cartilage damage, bone degeneration, arthritis)
  • Joint stiffness (Talocrural, Subtalar, Tarsals, Metatarsals)
  • Poor Leg Biomechanics (flat feet, immobile joints of the foot/ankle/knee/hip)
  • Muscle Tears/Spasm (Muscular, musculotendinous junction)
  • Tendonitis
  • TibioFibular Joint dysfunction
  • Anterior (front) or Posterior (rear) Impingement
  • Talar Dome fracture / cartilage damage
  • Dislocation of bones
  • Subluxation / Dislocation of tendon(s)
  • Avulsion Injury (pulling off a piece of bone)

ankle anatomy

WHAT IS AN ANKLE SPRAIN?
The ankle joint is made up of four bones. The shape of each bone helps make the joint stable. Stability around the joint is increased by ligaments, which are bands of strong connective tissue.

When the ankle twists, the ligaments usually prevent the joint from moving excessively.
An ankle sprain occurs when one of the supporting ligaments is stretched too far, causing the ligament’s fibres to tear and bleed into the surrounding tissues. This bleeding causes pain then swelling.
If your ankle hurts, don’t ignore it. Physiotherapists are well trained to give an accurate diagnosis and treatment the problem. We can refer for MRI, CT, X-ray, Ultrasound or blood test as required. We are able to provide a proven, safe and effective treatment.
Physiotherapy Aims
1) Treat the pain and other symptoms
2) Help identify the causes to prevent recurrence and
3) Provide self-management strategies

Treatment: Strong Evidence in Literature
1) Specific Ankle strengthening and general exercise programs
(ankle stabilisation)
2) Ankle Bracing

3) Mobilisation, Manipulation and Hands On Therapy
(Manipulation is traumatic and should only be used for certain conditions)
4) Acupuncture / Dry Needling
5) Orthotics
6) Sport / Work / Activity specific sterngthening program
7) Electrotherapy(TENS)

8) Balance Retraining (proprioception)

Treatment: Others
1) Postural Modification
(taping, innersoles, orthotics, body awareness exercises)
2) Hydrotherapy (great supportive environment)
3) Supportive Taping / Bracing
4) Use of Gels, Creams, Hot & Cold

Ankle pain is very individual due to the large number of structures and factors that contribute to your condition. What works for others may not work for you and you will have to trial various treatments under the guidance of your Physiotherapist to find what works for your particular condition.

WHAT SHOULD I DO AFTER A SPRAIN?
In the first 72 hours after injury, use the R.I.C.E.R method:

Rest:  Take it easy, but move within your limit of     pain. (may need crutches or brace)
Ice: Apply ice for 15 minutes every 2 hours. This helps control pain and bleeding.
Compression: Firmly bandage the entire ankle, foot and lower leg.
Elevation: Have your ankle and leg well supported, higher than the level of your heart. This reduces bleeding and swelling. If there is still swelling and pain after 24 hours, visit your local physiotherapist or doctor.
Review Get your Physiotherapist / GP to look


Your chances of recovery will also be helped if you avoid the H.A.R.M. in the first 72 hours.

Heat: Increases swelling and bleeding.
Alcohol: Increases swelling and bleeding.
Running or exercise: Aggravates the injury.
Massage: Increases swelling and bleeding


HOW CAN PHYSIOTHERAPY HELP?
Prompt Physiotherapy treatment will reduce the swelling, making it easier to walk, protect the injured area and promote healing.

HOW SOON CAN I RETURN TO WORK OR SPORT?
This will depend on how badly you have damaged the ankle. Returning to work or sport too early can delay healing and prolong recovery.

Bracing and taping may allow early return to sport, but normal ankle ligament strength and muscle control will take longer to return than the time it takes for pain and swelling to subside. Your Physiotherapist can also help you plan ways to maintain fitness while your ankle is healing.

For more on What You Can Do for Treatment Click Here