As a father of two high school soccer players, I am always fearful about the potential injuries to my kids. Also, I am concerned about the possibility of long term effects of an injury that has not been fully rehabbed. As a physical therapist, I have evaluated and treated many people who have fallen into that category. One of the most common conditions is recurrent ankle pain following an ankle sprain.
Ankle sprains are one of the most common musculoskeletal injuries with 85% of sprains being lateral ankle sprains (" rolling the ankle"). Healing of the injured ligaments can take up to 6 to 12 weeks. An estimated 30% of individuals suffering from an ankle sprain will experience persistent symptoms such as weakness, pain, feeling of the ankle “giving way" or "wants to roll” and functional limitations in their sporting or normal everyday activities. Additionally, a history of a previous ankle sprain is the most common predisposing factor in recurrent ankle sprains.
Traditionally, treatment for an acute ankle sprain is usually X-rays to rule out a fracture, immobilization (brace or cast), non-weight bearing with crutches and R.I.C.E. (Rest, Ice, Compression, and Elevation). Early return to normal extremity function is a key objective in managing mild to moderate soft tissue injuries. Recent studies have shown that early interventions such as partial weight bearing with crutches, especially with Grade 1 and 2 sprains, manual ankle mobilization, modalities (i.e. electrical stimulation, ultrasound) and rehabilitation exercises help assist in the short term in improving range of motion and function, decreasing pain and swelling and reducing the frequency of reoccurrence.
Receiving a course of physical therapy for an ankle sprain is crucial. An initial evaluation is performed to establish a baseline for pain level, swelling, range of motion, flexibility, strength, gait pattern, and function. Depending upon the severity of the sprain, level of pain, and baseline objective measurements; a rehabilitation program is developed uniquely designed for you. Treatment will include range of motion, flexibility, open and closed chain (non weight bearing and weight bearing) strengthening, balance and proprioceptive exercises along with gait training to normalize your walking pattern and the possible use of modalities to control your pain and swelling. Home exercises will be given in order to continue with the rehab process when you are not at therapy. As you progress, agility and sport specific exercises will be incorporated. Variations to this rehab process are dependent on the patient's tolerance and response to their individual treatment. Our ultimate goal as physical therapists is to have our patients return to their sport or work as quickly and safely as possible and to prevent the possibility of chronic ankle issues.
John Ciavaglia, P.T.