Ankle Sprains - Fighting Fit Physiotherapy Nerang Gold Coast

If you have ever played sports, there is a pretty good chance that you have had an injured ankle or at least seen someone who has.

Research suggests that sprained ankles are the most common musculoskeletal injury in the sporting population.

However, this injury is also more common than you may think in the general population.

You can sustain an ankle sprain while out on walks, working in the garden, chasing the dog and playing around with the kids.

Recurrence rates of ankle injuries are also very high, meaning that many of people end up having chronic ankle conditions.

For this reason it is extremely important to seek treatment early from the first instance.

An ankle injury occurs when the foot twists or rolls beyond it’s normal limits of the ankle joint putting the ligaments and joint under stress.

At a certain point these ligaments become over-stretched or damaged and thus an ankle sprain occurs.

The damaged ligaments then cause an inflammatory response resulting in ankle pain, swelling, redness and bruising around the joint.

It is important to rule out any ankle fracture or “Broken Ankle”.

You would be surprised how often a fracture is involved and missed thinking it’s just a common ankle sprain.

Redness, swelling and bruising are common signs of an ankle injury!

Ankle injuries are typically talked about in grades:

Grade 1: Slight stretching and some damage to fibers

Grade 2: Partial tearing of the ligament

Grade 3: Complete tear or rupture of the ligament

Avulsion fracture. This occurs when the ligament pulls off a piece of bone before getting damaged itself.

Below is a diagrammatic representation of three grades.

Let’s discuss what makes up the ankle!

The ankle has ligaments on both the medial (inside) and lateral (outside) aspect of the joint.

These ligaments help stabilise the ankle joint and serve as a guide to direct ankle motion.

The most common injury is typically a lateral ankle sprain due to the make-up of the foot, our movement and the strength of the ligaments there.

Three ligaments help stabilise the ankle on the lateral side. These ligaments are:

Anterior talofibular ligament (ATFL),
Posterior talofibular ligament (PTFL) and the
Calcaneofibular ligament (CFL).

The ATFL is the most common ligament that is injured in a lateral ankle sprain.

On the medial side, the ankle is stabilised by the deltoid ligament which is made up of 4 ligaments and is extremely strong.

We have talked about lateral and medial ankle sprains but there is another type of ankle sprain that is also fairly common and misdiagnosed.

This is called a high ankle sprain.

A high ankle sprain occurs when there is damage to a different ligament called the anterior inferior tibiofibular ligament.

We’ll touch on this in a further blog!

Above is a picture of the bones and ligaments of the foot and ankle!

How is an ankle strain diagnosed?

Due to the number of structures involved in the make up of the foot and ankle, we will need to perform a full foot and ankle assessment to diagnose your injury.

This includes

Range of Movement Testing: to see how affect the movement is
Strength Testing of the muscles to see how weak or impaired they have become
Proprioception Testing of the lower limb, foot and ankle to determine if your joint position sense is affected
Gait Analysis or walking or running
Special testing of the ankle ligaments to determine which are injured and affected by the injury.

A knee to wall test will tell you if you have a restriction in ankle range of movement. Try it at home, if you have a difference side to side following injury then you need to get it moving!

How is an acute ankle injury managed?

Treatment will always depend on the individual presentation of the patient however there are some things that you can do in the initial stages to assist with better outcomes.

As with most injuries it is important to follow the direction of a qualified health care provider.

There are some principles around soft tissue management for ankle injuries, you might have heard of some.

ICE (Ice – Compression – elevation) or
RICER (Rest -Ice – Compression – Elevation – Rehabilitation/Recover) or
POLICE (Protect – Optimise – Load – Ice – Compression – elevation)

But the latest is PEACE and LOVE!! (BJSM, 2019)!!

These principles apply for acute, sub-acute and chronic injuries or immediate care (PEACE) and ongoing care (LOVE).

Here is what they mean!

P.E.A.C.E

PROTECTION: from further injury for days to weeks post

ELEVATION: Higher than the heart as often as possible

AVOID ANTI-INFLAMMATORIES and ICE: They may slow tissue healing when used incorrectly

COMPRESSION: use elastic bandage such as tubi grip

EDUCATION: Understand your condition, gain advice from a reputable source

L.O.V.E

LOAD: Graded loading during tissue healing is important. Pain is respected but not feared!

OPTIMISE: Conditioning your brain for optimal recovery by understanding your condition, being confident that your body will heal and is designed to do just that.

VASCULARISATION: Choose pain free cardiovascular exercise early on to increase blood flow to repairing tissue/s

EXERCISE: plan rehabilitation and building back up to normal over time using mobility, strength, proprioception and adopting an active approach to treatment will increase confidence and normalise function again

Should I ice my ankle?

Despite the above, we are not completely against it, but not all injuries need to be iced.

Applying ice to the ankle may help with the pain management (analgesia).

A tip to remember is if ice assists you ensure that you let the ankle naturally return to body temperature before re applying.

More often then not people over do the ice part, either too cold or too long, expecting it to reduce swelling. It doesn’t!

Should I brace or immobilise the ankle?

In some cases, it will be important to immobilise the ankle for a period of time.

This is where we come in and after an in-depth assessment the therapist will indicate what form of immobilisation (ie ankle brace or moon boot) you need and for how long.

We will also determine if further investigations are warranted to rule out fracture or serious ligament or joint damage.

During the period of immobilisation it is also important to continue with some light mobility & exercises in order to limit ankle joint stiffness.

Again we will guide you through this.

Once this period of bracing is over we will then guide you through a graded program focusing on rebuilding ankle movement, strength and proprioception.

Depending on the severity of the acute ankle injury and pain, a boot or brace maybe prescribed early on.

PREVENTING an ANKLE INJURY

Sounds like wishful thinking, right?

Prevention is always the key, especially when it comes to ankle injuries.

There is a lot you can do to limit your risk of injury through an appropriate strength and conditioning program tailored for you sport.

But injuries just happen and can’t be avoided in life. It is what you do when you injured that matters.

Leaving an ankle to get better on its own, not rehabilitating it, half arsing and not finishing the full course of treatment and injury rehabilitation JUST because pain got better, WILL CAUSE ISSUES IN FUTURE!

Physiotherapy for a sprained ankle

If you have recently or in the past sprained your ankle and want a great outcome.

Come on into the clinic and we will put you to work getting that ankle right again!

Above: Strength testing the muscles of the lower limb using our in house technology to track and monitor your progress!

Dean Phelps

Dean Phelps is the founding owner and senior physiotherapist at Fighting Fit Physiotherapy. He has a special interest in the highest physiotherapy care which focuses on progressive, results based treatments that ensures patients meet their goals, move optimally and enhance their health.

Brenda Samosa

05:52 07 Nov 24

I had a really bad shoulder and had been seeing a different physio for 3 months (from a different place) I got told Tyson was good. After just a few sessions the movement was coming back. I’m 66 and was worried I would have to stop surfing. But with a lot of help from Tyson I’m back in the waves ( thank you so so much)

Cyana Ferguson

08:16 30 Oct 24

Steve Harris

22:33 15 Oct 24

Great team, all friendly, super helpful and first class clinical advice and a big shout out to my Physio Noah with my shoulder issue

Andrea Bell

05:33 19 Sep 24

These guys are the best in the biz 🎉

Ryan Brockett

04:20 18 Sep 24

Shout out to Max from fighting fit physio. He helped me out massively straight after shoulder surgery and back into work and sports in no time. Couldn’t recommend anyone better!

Scotty

08:31 31 Jul 24

Five star service from Max & the team!
Professional & very thorough, you know that patient outcomes are of the highest priority.
I highly recommend this business.

Riley Wilson

08:27 14 Jul 24

Be AWARE they’ll immediately try to commit you to multiple follow up sessions after your initial consultation. This happened to me and then I later found out that as it just so happens, they have a cancellation policy that says you have to pay 100% of the consultation fee for cancelling. They failed to tell me this when they were pushy in committing me to 6 sessions after my consult, so that was a really nice little surprise.

I was already uncomfortable with how pushy they were in having me commit to so many sessions, so when I heard about the policy I just cancelled all together. So, I can’t speak further to the quality of their service throughout therapy phase. FYI this was also a few months ago now, it’s possible (though unlikely) they may have changed the policy. Just ask the question.

Megan Shelley

06:51 03 May 24

Fighting Fit Physiotherapy is hands down the best physio I've encountered. Having tried multiple physios for various injuries, I always find myself coming back to them. Their expertise consistently exceeds expectations, helping me get back to my sport faster than I thought possible. Their personalized approach and attention to detail make all the difference. I could not recommend a better or more exceptional physio team!

Gina Matthews

08:41 24 Mar 23

Can't recommend this place high enough. I was in so much pain with my knee an had been for months through advise an exercises I'm now looking forward to returning to gym an back riding my horses in endurance thank you so much

Courtney Halse

01:36 29 Nov 22

Kyle was knowledgeable, personable and professional. He saw me through my second pregnancy and continued to work with me until 6 months post partum on issues with my back. Would recommend anyone to go and see him.

Also shout out to Georgia on the front desk. She makes you feel welcome and brings a sense of warmth to the place!

Alli Davenport

08:07 04 Nov 22

After hip replacement surgery in February I wanted toget back into weight training legs, I started with Mitch 18 weeks ago and after a lot of hard work and sweat I am able to safely train again, I cannot thank Mitch enough for his support,encouragement and knowledge. The staff are friendly and helpful and I always looked forward to my session's

Robert Parkinson

10:50 15 Aug 22

This is the second time I have been treated by the team at FFP.
As a health professional myself I have been impressed with the level of care I have received from all members of the team.
The personalised treatment and rehabilitation programs have produced excellent results and I have completed both programs pain free and feeling stronger than before my injuries.
During the program there was constant communication and follow up and they were very accommodating with my work schedule.
All in all it was a very holistic experience and I would highly recommend the service.

Kiri Canavan

07:30 08 Jun 22

Tyson was amazing! We came up with an 8 week plan at my first consultation with weekly check ins and updates to exercises. 8 weeks later, I am pain free and able to train harder than ever. Highly recommend and the staff are all fantastic and super accomodating!

Ankle injuries are typically talked about in grades:

Let’s discuss what makes up the ankle!

How is an ankle strain diagnosed?

How is an acute ankle injury managed?

Should I ice my ankle?

Should I brace or immobilise the ankle?

PREVENTING an ANKLE INJURY

Physiotherapy for a sprained ankle

The Desk Worker’s Guide to a Pain-Free Neck

Hip Osteoarthritis: Why It Hurts and How Physio Can Help

The #1 Mistake Athletes Make After an Ankle Injury

The Secret to Beating Back Pain? Walk This Way!

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