If you’ve been to see your doctor, they may recommend physical therapy. For those of you that have never been to PT, here are some things you can expect.
Lateral ankle sprains are very common and many mild sprains will heal without need for focused rehab (Ice is your friend!). We are often asked ‘Do I need physical therapy if it’s just a simple ankle sprain?’
Firstly, RICE (rest, ice compress, elevate) will likely be recommended. However, if pain and symptoms persist beyond 10-14 days, then it is a good idea to follow-up with a doctor or physical therapist. Finally, more moderate and severe sprains may need immediate attention, and are more likely to show up in our PT clinics.
When these patients do come in, therapists will usually have three main priorities:
- Address pain and swelling¹
- Return to full function ASAP
- Prevent re-injury
It should be noted that while many ankle sprains may be mild injuries initially, they can also have high rates of re-occurrence; especially, if they’re not properly treated. Approximately 70-80% of ankle sprains experience re-injury on the same side and some patients may develop chronic symptoms of ankle instability.
Patients at a higher risk include athletes in sports that involve movements such as cutting and lateral motions. In most cases, sprains usually involve ankle ligaments. However, in chronic cases, sometimes it is an issue with the nerves including proprioception (part of our sense of balance) and motor control (muscles working at the correct time).
What exercises are recommended?
Proprioceptive training is often one of the most overlooked parts of ankle rehab. In short, it is our body’s communication between the brain and our muscles and joints. This two way communication plays a huge part in our balance and maintaining our steadiness on our feet. Therefore, since injuries frequently disrupt this communication, it may remain a problem long after swelling and pain resolve.
In fact, our central nervous system is so important in this area, that some research² has shown that patients can improve balance on their injured leg simply by performing balance exercises on the opposite leg.
Is a brace necessary?
Another common question is if someone needs a brace or crutches. Our best evidence suggests that early weight-bearing with support devices such as a brace lead to faster recovery than non-weight bearing rigid immobilization such as a cast³.
Due to our push to get patient’s able to walk and bear weight comfortably, we often encourage the use of the least restrictive device necessary. For some, that may mean a lace up brace, whereas for others, it may be a walking boot for a few weeks in cases with more serious sprains.
Here are a few examples of the things we take into consideration with ankle injuries from a physical therapist’s perspective:
As with any injury, we will always track pain, swelling, range of motion, and strength along with other objective measures to monitor progress throughout a treatment plan and make adjustments accordingly.
Above all, we rely on our patients being actively engaged in their treatment from start to finish. This ensures we are reaching their personal goals for therapy and return to normal daily activity. Make sure to get your ankle looked at by your physician or physical therapist if you symptoms persist for longer than 10-14 days!
Mark Jagger
PT, MSPT, OCS / Board-Certified Clinical Specialist in Orthopedic Physical Therapy, SERC Physical Therapy (913) 764-0389
References
- Kerkhoffs GMMJ, Rowe BG, Assendelft WJJ, Kelly KD, Struijs PAA, Van Dijk CN. Immobilisation for acute ankle sprain. Arch Orthop Trauma Surg. 2001; 121(8):462-471.doi:1007/s004020100283
- Hale SA, Fergus A, Axmacher R, Kiser K. Bilateral Improvements in Lower Extremity Function After Unilateral Balance Training in Individuals With Chronic Ankle Instability. J Athl Train. 2014;49(2):181-191. doi:10.4085/1062-6050-49.2.06
- Martin RL, T. E. (Volume 43, Issue 931 Aug 2013). Ankle Stability and Movement Coordination Impairments: Ankle Ligament Sprains. Journal of Orthopaedic & Sports Physical Therapy, Pages A1–A40.
