Sprained Ankle? Now what…

I first sprained my ankle on December 23rd, 2016 jogging back to the swing dance classroom.  It was by far the worst sprain I’ve had in my life.  But, thanks to awesome swing dancing friends, I shortly had my ankle propped up, iced, and comfort food within an hour.  Soon after, I purchased an ankle sleeve to help with compression to control swelling and provide minor support.  It was feeling pretty good, so I decided to go hiking on New Years, and I sprained it again.  From what I can tell from my schooling, I’ve gone from a Grade 1 to a Grade 2 sprain.  But what does that mean?

In my previous post, I talked about prevalence of ankle sprains, what increases your risk of spraining your ankle, and what the grades mean.  In this post, I’m going to talk more about the healing times for the different ankle grades.

  • Grade 1 – Mild Ankle Sprain
    • No bruising, point tender, minimal swelling
    • Little or no limp, difficulty hopping
    • Weight bearing as tolerated, no splint
    • Recovery – 8 to 10 days
  • Grade 2 – Moderate Ankle Sprain
    • Some bruising, local swelling, when tested – some extra joint play in one test
    • Limp with walking, can’t tip-toe, hop, or run
    • Air splint
    • Recovery – 20 days
  • Grade 3 – Severe Ankle Sprain
    • Bruising, swelling on both sides of Achilles tendon, when tested – extra joint play in both tests
    • Can’t bear weight on it fully, almost complete loss of ankle motion
    • Ankle is immobilized
    • Recovery – 40 days (1 – 1.5 months)

So, during this time, what should you be doing?  One of the most important things is to R-I-C-E: rest, ice, compress, and elevate.  When you elevate the ankle, you want to make sure it is above your heart level.  Honestly, you want to get it as high as possible.  It may look silly, but you are preventing extra swelling which can lead to increased pain.  With ice, it’s best to ice it up to 20 minutes at a time, and you should have a thin layer between the ice bag and your ankle.  If you don’t have an ice pack, a pack of frozen veggies works great.  (I used edamame; it works!)  You also want to stretch the Achilles tendon within 2 to 3 days no matter your weight bearing ability.  This is because tissues tend to contract after an injury.

If you go to physical therapy with an ankle sprain, you can expect your rehab to have the following aspects:

  • First, it’s important to get back full movement in your ankle.  However, you will avoid plantar flexion and inversion (pointing your foot, sole towards the other leg) because this stresses the hurt ligament.
  • You also want to get back to normal walking; this might include crutches or splint supports.
  • There will likely be an emphasis on icing, compression, and elevation to prevent further swelling.
  • When appropriate, there will be a focus on strengthening the peroneals (the outside lower leg muscles that help to prevent ankle sprains) and dorsiflexors (bringing your toes towards your nose.)
  • Working foot intrinsics – these muscles control the movement of your toes.  Strengthening these can improve foot health and help get rid of extra swelling.
  • Proprioception and balance training – this helps you to increase your awareness of the joint position and muscle firing of your ankle.  This is vital to preventing future ankle sprains.

So far, I’m just trucking along in this process and taking it easy for the next two weeks.  What questions do you have?  Have you had an ankle sprain before?

References:

Management of Ankle Sprains

Grade of Ankle Sprain Chart

I am so thankful to Greg Todd & Smart Success PT for all that I have learned about physical therapy and businessPre-register for  Smart Success that re-launches in January. Be the first to know how to Change you Career!!

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