Ankle Sprain Therapy

Ankle sprains are a common sports injury, but should not be treated lightly. Improper treatment and rehabilitation can result in a weakened ankle and susceptibility to re-injury. The three R's of ankle injuries are rest, rehabilitation and return to use. You should always get a doctor to look at the injury to insure you haven't broken or severely damaged anything before beginning a treatment regimen.

Diagnosis

• When you see your physician, he or she will probably order X-rays to rule out broken bones and an MRI if torn ligaments or joint damage is suspected. The doctor can then tell you what grade of ankle sprain you have, based on how much pain you have and the degree of swelling and bruising. Once you know the severity of the sprain, you can begin one of the following treatment strategies.

Grade 1

• A grade 1 sprain relies on the R.I.C.E. protocol, familiar to athletes and trainers. First, "rest" the ankle by getting off of it. "Ice" should be applied to reduce the swelling. Use ice 20 to 30 minutes at a time, three or four times a day. Use "compression" bandages, elastic wraps or similar dressings to support the ankle and reduce swelling, pain and tenderness. Finally, "elevate" the ankle above the heart as much as possible for the first 48 hours after injury.

Grade 2

• Use the R.I.C.E. protocol for a grade 2 sprain, but allow more time for healing. You may have to stay off the sprain longer, elevate it for a few extra days or use a special to promote faster healing.

Grade 3

• The severity of grade 3 sprains can lead to permanent ankle damage and instability of gait. Surgery is usually not needed unless the ankle doesn't heal. The doctor may put the leg in a short leg cast or a cast-brace appliance for two or three weeks. The R.I.C.E. protocol is essential in the early stages of the injury. Your physician will be rather more directive about how long to continue R.I.C.E. because of the severity of the injury.

Rehabilitation

• Professional rehabilitation may be called for with grade 2 and 3 sprains. Treatments like ultrasound, electrical stimulation to control pain and swelling, range of motion activities and physical therapy may be ordered. Water exercises can be used if the ankle is too tender. For severe or prolonged injury recovery, the therapist may include kinesthetic and propriception therapy to helps the injured person recover movement and awareness of the joint's position and role in walking and athletic activities. Exercises to increase strength, balance and range of motion will be part of this training.

Returning to Activities

• In the latter stages of rehabilitation, you should return to your regular activities slowly. Do not stress the ankle at first. Avoid twisting, sharp turns or bouncing till you've had a few weeks of maintenance exercise like walking toe-raises and hamstring stretches. Your trainer or therapist can suggest other low-impact ankle strengthening exercises. Full recovery can take from three weeks to several months depending on the initial severity of the injury and how well you stick to the recommended rehabilitation regimen.