Ankle sprains are one of the most prevalent injuries in sports, affecting athletes of all levels and disciplines. Whether it's basketball, soccer, running, GAA or any other activity that involves running, jumping and sudden changes in direction, the ankle joint is particularly vulnerable to sprains.
Understanding Ankle Sprains:
An ankle sprain occurs when the ligaments that connect the bones of the ankle joint are over-stretched or torn. Ligaments provide stability to the joint and help prevent excessive movement. The most common type of ankle sprain is a lateral ankle sprain, which affects the ligaments on the outer side of the ankle.
Causes: Ankle sprains typically occur when the foot rolls inward (inversion) or outward (eversion) forcefully, straining the ligaments beyond their normal range of motion. This can happen during activities that involve sudden changes in direction, uneven surfaces, or direct contact with another player. There is also a risk of bony injury during ankle sprains such as avulsion fractures.
Symptoms: The symptoms of an ankle sprain may vary depending on the severity of the injury. Mild sprains may cause minimal pain, slight swelling, and some difficulty in bearing weight. Moderate to severe sprains can result in intense pain, significant swelling, bruising, instability, and difficulty walking.
Treatment Options for Ankle Sprains:
Immediate care and proper treatment are essential to promote healing and prevent long-term complications. Here are the common treatment options for ankle sprains:
POLICE: Protect, Optimally Load, Ice, Compression, and Elevation is the first line of treatment for ankle sprains. Allowing relative rest of the injured ankle but getting it moving as soon as is safe to do so, applying ice packs to reduce swelling, using compression bandages to provide support, and elevating the foot above heart level to help to manage swelling.
Pain Management: Over-the-counter pain medications non-steroidal anti-inflammatory drugs (NSAIDs) can help alleviate pain and reduce inflammation. However, these are not always beneficial and it's important to consult a healthcare professional before taking any medication.
Immobilisation: Depending on the severity of the sprain, immobilisation may be necessary to allow proper healing. This can involve wearing a supportive brace, boot or splint for a period set by your healthcare practitioner. Crutches may also be used for severe ankle sprains to keep weight off the injured ankle during the initial stages. However, if it is safe to do so, early movement and loading of the ankle joint as tolerated can result in a more efficient recovery than total rest in the acute phase.
Rehabilitation Exercises: As the ligaments begin to heal, rehabilitation exercises play a vital role in restoring strength, range of motion, and stability and getting you back to playing your sport. Physiotherapy exercises, such as ankle stretches, range-of-motion exercises, strengthening exercises, and balance training are frequently prescribed depending on your individual presentation after assessment. These exercises will need to be progressive and it is common to attend a number of physiotherapy visits to re-assess and advance your training as the ankle heals to ensure optimal recovery. At Restore Physiotherapy we take a holistic approach to all injuries and your physiotherapist will also look at risk factors that may have made you more vulnerable to this injury (including footwear, biomechanics, baseline strength and mobility levels, training load history and exercise technique) and address these as part of your rehabilitation programme. On return to sports we may recommend taping of your ankle joint to support the ligaments for the initial few weeks back.
In severe cases or if certain criteria are met we may recommend imaging tests, such as X-rays or MRI scans, to objectively assess the extent of the injury and rule out any fractures or other complications.
To conclude, ankle sprains are common musculoskeletal injuries in sports, affecting athletes across various disciplines. Understanding the causes, symptoms, treatment options, and preventive measures for ankle sprains is crucial for athletes, coaches, and trainers. By working with your physiotherapist to rehabilitate your ankle and address risk factors that can leave you vulnerable to a recurrence of this injury, athletes can significantly reduce the risk of future ankle sprains. Furthermore, prompt and appropriate treatment, including optimal loading, rehabilitation exercises, and professional medical evaluation when necessary, can aid in a speedy successful recovery. Remember, prevention is key, and taking proactive steps to protect the ankle joint can help athletes stay in the game and minimise the impact of these common sports injuries.
Am I ready to explore?
I have been asking myself this question recently. Even though I work as a physiotherapist, I have been moving less and spending more time on my laptop during the last few months. I have also had more pains and niggles. I am working on exploring the nature of these pains and niggles, alongside increasing my movement in a way that I enjoy. This blog may be useful for people who are managing pain and also for those who are considering increasing their physical activity.
I want to share with you an approach that has been helping me personally and also many of my clients when exploring movement and pain. This approach begins with looking ‘within’ prior to taking action. The aim is that by exploring inwardly, I am allowing the right action for me to become clear. I want more and more of the actions I take to emerge from my own internal impulse and be less driven by external stimuli. In this way, exploration of my movement and of any pain I experience will be an exploration of myself – my body, my inner world and my purpose.
Are you ready to explore?
Let’s start by exploring our awareness of our movement.
Whether we feel in good shape or that we have been neglecting our body this process can offer benefit. Let’s be very honest but also non-judgemental with ourselves in answering these questions.
How often do we move throughout a normal day?
How do we feel in our body?
Where do we feel strong and capable?
Where do we feel weakness or vulnerability?
What does our body need help with (physical, nutritional, emotional)?
Our body is our nomadic home! It is engineered for movement. It can:
Perhaps we haven’t engaged in some of these movements for a while. However, where ever you are physically right now, that is exactly where you need to be. We do not need to be critical of this place. Let’s welcome this as our starting point.
One thing I can guarantee is that your body is an adaptation machine! If you challenge it, it will adapt and create change. If you don’t challenge it, it will also adapt, and become accustomed to not being challenged and not needing as much muscle mass etc.
We know that there are many benefits to movement. We also know that it is healthy for us to engage in resistance and cardiovascular training each week. This is useful to know but isn’t always motivating. Can we approach our motivation for movement and exercise from a different perspective? Can we find the motivation to move from within us – from a place of fun and enjoyment?
Maybe you have fallen out of love with movement or maybe out of habit. Maybe exercise was never something you enjoyed. So how can you find ways to move that you enjoy? Do you like the social element / do you like personal space? Do you like to move in nature or in a gym? There are many ways of moving. The key is that you find a way of moving that brings fun!
Here are some examples of a variety of movement options: physiotherapy-led sessions, personal training sessions, group classes, yoga, walking, pilates, dance, zumba, parkour, gymnastics, martial arts, field sports, hiking, rock climbing, running, weightlifting, horse-riding, swimming, surfing, cycling etc…
Do any of these call out to your body?
Wouldn’t it be great to be able to move your body in the way it needs without it ever being a chore or a ‘to-do’ list item. Would you be open to exploring how you can become empowered through movement and enjoy connecting with your body?
Let’s now look at exploring pain and our bodies.
On a simple level, a pain experience is ‘feedback’ from our nervous system warning us that it is not feeling comfortable with something.
How do we approach this ‘feedback’ when it presents itself?
As pain arises, being able to pause and listen to the ‘feedback’ it is offering can be helpful. Start with a mental scan through your body from your feet and up to your head. As we scan can we accept how we currently are without wanting it to be other than it is. This can be very challenging as we often have our own stories and strong emotions alongside areas of pain/discomfort. Let’s try to leave our stories and thoughts about our pain to one side for a moment. Let’s tune into the actual sensations that we are feeling in an area of pain/discomfort, as they are.
What if we take away the word ‘pain’? Can we describe any uncomfortable sensations with more specificity: e.g. right now in my neck I feel a heaviness and an ache in my left jaw. Can we map the territory of these sensations? I notice the ache is centred around my jaw and moves through my gums. I notice the heaviness is coming from the bottom of my skull to my shoulders. As I notice these physical feelings I am not getting stuck in judgement or frustration that they’re there – I’m simply observing and listening.
As we scan we may notice we are holding tension or tightness in certain areas. The next step is to give these areas the opportunity to soften. Can we allow our breath to gently deepen as we relax our body. As I write I am checking in with myself and noticing tension in my jaw, and also that I’m leaning towards the screen and my shoulders have elevated. I now take longer and deeper breaths, I allow my elbows to drop, I soften my jaw and I relax my neck. It takes a few seconds, and it brings my awareness to patterns of tension I may be holding, and allows me to change them.
As we explore parts of our body an emotional response may arise. Emotions are felt physically in the body and often have thoughts associated with them. Difficult emotions can be quite uncomfortable to experience. If you feel able to, see if you can allow an emotion to come up without pushing it away or trying to change it. Thich Nhat Hanh, a buddhist monk, talks about the practice of welcoming uncomfortable feelings. We can speak to an emotion as it rises: ‘hello my anger, you are welcome’.
This is a tool to enhance our awareness of the feedback from our bodies and nervous system. This will help us on our journey to managing pain. It will also involve movement and may involve medical support/therapy as appropriate.
If you would like support with pain or discomfort or to get help with movement please feel very welcome to contact me (www.restorephysio.ie or [email protected]).