Did you sprain your ankle…again? Well, you’re not alone. Ankle sprains are one of the most common problems among people. According to the American College of Sports Medicine, there are 25,000 Americans suffering from ankle sprains each day (1). However, there are some holes in the traditional rehabilitation information given to us by medical professionals. This article will give you the complete essentials of what to do after twisting your ankle.
The reason why I’m writing this article is that too often, I meet people in my physiotherapy practice or in my free time that have been left without proper information, instructions and rehabilitation programs leaving them in a vicious circle of pain, inflammation, limited range of motion and poor stability. Many times, we also tend to neglect first aid and important rehabilitation steps leaving us with chronic ankle issues which never seem to disappear.
Regular folks especially athletes are struggling to prevent ankles sprains from happening again and again. It’s important to note that once you twist your ankle and sprain the ligaments for the first time, there’s more than a 50% risk of going through it again if you don’t receive proper information and treatment.
Quick Review: What Is It and What Happens When You Sprain the Ankle?
There are two sets of ligaments in the ankle namely; those which are inside the ankle and those that are on the outer surfaces of the ankle. Most commonly (over 80% of the cases), it’s the outer ones that sprain when we twist the ankle inwardly. It can happen when we step on a stone or play an intensive sport like football.
The ankle nerves and ligaments in the ankle are tired or lack circulation and nutrients leading to the inward “roll” of the ankle. An intense pain occurs followed by swelling as a result of normal acute inflammatory and bleeding processes.
The most important message is to ensure you treat the injury (from the first second when you twist your ankle to the next three weeks) if you are keen on having a 100% functional ankle once again. One more thing; excess consumption of fresh fruits, berries, vegetables, nuts, seeds and water is crucial. Without drinking at least 2 liters of pure water and eating at least 7 portions of fresh produce daily, you will definitely end up with future ankle issues. The healing can’t proceed optimally without these vital factors.
The Optimal Rehabilitation Progress in Ankle Sprain
1.) THE FIRST THREE DAYS: PRESSURE, ELEVATION AND COLD IN THAT ORDER
After experiencing the terrible pain that follows when you twist your ankle, the first thing you should do is apply hard pressure to the ankle by yourself or seek the help of someone else who is close to you at that moment. This is important because it prevent the excess fluids and blood from entering the ankle joint. If this action is not performed immediately, you risk delaying healing by a few days. So, first apply pressure with your hands and then tie the ankle up tightlywhen you get access to bandages.
It’s also vital to keep the leg in an elevated position from the first moment on and during the next three days. You can put something cold on the ankle i.e. ice packs when you get home. In the previous acute stage, it’s not so essential however, it’sgood if you have access to them. It’s more important to apply the cold for the next three days after the injury. Apply it for 10 minutes at a time for many times a day (i.e. at least 5 times/day). Inflammatory medication should also be taken for the first three days only.
2.) DAYS 3-7 (HEAT, LIGHT MOTION AND LIGAMENT GUIDANCE)
Now we have stopped the excessive blood and fluid flow into the ankle with pressure, elevation, ice and rest. However, after three days, the ankle wants to begin its healing and eventually restorenormal function. It wants to get rid of that excess fluid and dried blood restricting the normal motion of the ankle. Therefore, we actually need a little extra warmth and blood circulation.
Begin to apply heat packs or put your ankle in a bucket filled with warm water and start moving the ankle lightly. Just flex and extend the ankle while respecting the pain. This will help pump some blood, oxygen and nutrients into your ankle making the healing faster. If your ankle allows, light walking is recommended with the aid of crutches.
Another commonly overlooked but important treatment is light massage. You should massage the sprained tendons and ligaments lightly. Seen here (2). These are the most common places where injury occurs. So, palpate with your fingers and when you find a sore point, massage it lightly for 1-2 minutes (max) per day, every day. This is due to the fact that tendons and ligaments don’t have normal effective blood circulation like the muscles do. It’s therefore an absolutely important part of the rehabilitation process especially after 7th day.
3.) AFTER DAY 7 (LIGHT WEIGHT BEARING AND BALANCE)
This is the most common point for people to start rehabilitating ankle sprains. The first two previous stages are often neglected so the healing process is delayed vastly. Many times people go to the doctor only until after the first week due to the fact that they still suffer pain and swelling.
Continue to massage the tendons and ligaments 2-5 minutes daily to improve blood flow in them. This also helps to guide the ligaments to grow into the right direction. This can be done at least in the first 21 days after an injury and be followed up if found helpful.
The “normal” rehabilitation process begins at this stage. Light weight bearing and one leg balance exercises should be started in a progressive manner at this stage. Also, the force and velocity of the movements and exercises can be increased gradually.
It is also advisable to use kinesio tapingfor the next few months after the injury. This tape helps the strained nervous tissue in the ankle to be more active preventing you from further injuries.
By TeijoVienola, a former professional floorball player (intensive Scandinavian ball game), U19 bronze medalist, physiotherapist, nutrition consultant and a former patient who sprained his left ankle 8 times and the right one, 10 times. He is also a writer for Kikulife helping people to get healthier through natural nutrition and functional exercising.
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