Quote: An ankle sprain can also happen when one does not wear proper shoes or ambulate on uneven surfaces.
A lot of us have probably sustained a sprained ankle whether from sports or just taking a misstep. However, how many of us saw a professional to seek help and care for the damaged joint?
We speak to physiotherapist Yvette Tan on ankle sprains and what best to do when it occurs and aftercare. Yvette has had five years of experience in physiotherapy.
1Twenty80: Firstly, what is a sprain and how can it occur?
Yvette Tan: A sprain indicates ligament tear. In the case of an ankle sprain, it is an unexpected awkward twisting of the ankle that tears the ligaments connecting the bones at the ankle joint. It is commonly acquired during sports where the person is required to move away from a spot consistently, such as basketball, football, running, lion dance, dancing and more. An ankle sprain can also happen when one does not wear proper shoes or ambulate on uneven surfaces. A person who has sustained any form of injury at the ankle, such as a fracture or even an old ankle sprain, can leave the ankle vulnerable to repeated ankle sprains in the future if the muscles surrounding the ankle are not strengthened and stretched adequately.
1Twenty80: Who are at higher risk of an ankle sprain?
Yvette: Professional athletes; those who engage in casual sports, cultural dances or martial arts; improper footwear such as wearing the wrong shoe size and using shoes with heels while walking on uneven ground; old injury of the bone, muscle or ligament sustained at the ankle; insufficient and inadequate stretching and strengthening of the muscles surrounding the ankle; and any neurological conditions that affects the ankle’s stability, flexibility and muscle weakness, such as spinal cord injury or stroke.
1Twenty80: Once a sprain is sustained, what are the first few things that must be done?
Yvette: Immediately follow the RICE protocol:
Step 1: Rest the sprained ankle by not walking or putting weight on it.
Step 2: Ice the sprained ankle for 15 minutes at a time, and repeat icing every two hours during this acute phase (72 hours after sustaining ankle sprain). This will keep the inflammation down by causing vasoconstriction of the blood vessels. Apply a thin fabric like a cloth around the ankle and do not apply ice directly on the skin to prevent ice burn.
It is hard to know how cold the ice is at the time of application. To know whether it is safe to continue icing, follow the CBAN rule:
- a) Coldness of the ice should be felt over the skin.
- b) Burning sensation would be felt over the skin after the cold sensation last about three to five minutes.
- c) Aching could set in after the burning sensation.
- d) Numbness felt after the aching sensation indicates that the ice should be removed and discontinued. The continuation of application could result in an ice burn.
The CBAN rule is applicable to any form of cold therapy like cold packs and ice cubes.
Step 3: Compression is applied on the sprained ankle by bandaging it with compression dressings, bandages or ACE wraps in a figure-of-8. Such compression will immobilise and support the sprained ankle, also reduce blood pooling around it. Take note that the bandages are not too tight to the point that it cuts off circulation.
Step 4: Elevate your ankle above the level of your heart while you’re lying down for the initial 48 hours after injury.
1Twenty80: What are common problems that may stem from not treating your ankle problems?
Yvette: Complications of failing to treat an ankle sprain properly, engaging in activities too soon, and getting repetitive ankle sprains, could result in chronic ankle pain, chronic ankle joint instability and ankle joint arthritis.
1Twenty80: What examples of exercises that we can do after sustaining an ankle sprain?
Yvette: There are three phases to go through to recover from ankle sprains:
Phase 1: Rest, protect and reduce swelling of the sprained ankle.
Phase 2: Restore ankle range of motion, improve its strength and flexibility.
Phase 3: Exercises to gradually improve ankle stability and proprioception, and exercises for endurance and agility required in sports or activities.
It is best to have a physiotherapist assess the sprained ankle and follow through with you the tailored exercise program.
1Twenty80: What are signs that you need to see a professional?
Yvette: See an orthopaedic doctor or surgeon immediately when:
- After hearing popping sound or sensation when the ankle sprain happened.
- Excruciating pain felt in the ankle or its surrounding.
- Moderate or intense tenderness and swelling is present around the sprained ankle before and after performing RICE.
- Bruising is seen around the ankle within a week’s time.
- Ankle pain persist four to six weeks post-injury.
- Frequent recurring ankle sprains.
- If you’re unsure about the ankle sprain.
Quote: It is best to have a physiotherapist assess the sprained ankle and follow through with you the tailored exercise program.
There are three grades of ankle sprains. A mild ankle sprain would heal quickly with care but moderate and severe ankle sprains would require proper assessment and care. If a moderate ankle sprain is not attended to properly at the beginning, it could progress to become a severe ankle sprain.
Therefore, it is better to seek a doctor’s opinion than to misdiagnose and treat yourself wrongly. After seeing the orthopaedic doctor, it is safe to begin physiotherapy treatment immediately to accelerate the recovery unless contraindicated and require immediate surgery. If you’re unsure about the ankle sprain, do not hesitate to visit an orthopaedic doctor or surgeon, and a physiotherapist for assessment.
