Ankle sprains are one of the most common sports injuries - we see people coming into the clinic with ankle sprains every week. And one of the things many of them believe is that, once you have an ankle sprain, your ankle will stay weak, and you are likely to sprain again. Sadly it is common to re-sprain your ankle after one injury. In fact the greatest risk of spraining your ankle is having sprained it before in the previous year. But can the way you treat and manage your injury get a better outcome for your ankle?
The result of a recurring ankle sprain is often pain and disability, and reduced participation in sports and reduced physical activity. This is in part due to pain, and in part due to fear that the injury will happen again.
For the injured person then, the biggest question is "What can be done to help my ankle return to full function, and prevent this injury recurring?".
What can I do to recover fully from my ankle sprain?
Recovery from an ankle sprain can be broadly divided into 2 stages. The acute stage, and Rehabilitation Stage.
In the Acute Phase, management needs to focus on controlling swelling and supporting the ankle whilst the ligaments heal. We use techniques of ice, compression, elevation, and relative rest. But stopping treatment at this stage when the pain settles may leave the patient with an ankle that is weak, and vulnerable to re-injury. So the big question is what to do after the acute phase.
The Rehabilitation Phase - how to reduce the risk of recurrent injury.
From a review of good research studies, it is evident that the way to reduce risk of re-injury, and regain full function of your ankle is to continue to work on balance and strength for some weeks after injury, well beyond the stage of pain and swelling. In short this means working through a rehab program which retrains balance and joint position sense (proprioception).
In a large study in the British Medical Journal(1), 522 athletes with ankle sprains were studied. Half of them were prescribed an exercise program involving balance and strength training with the use of a wobble board for 8 weeks. Much of the program was carried out at home, but with careful instruction. The control group followed simple injury advice. The results of this study were convincing. The subjects in the group who followed the proprioception program had a 35% reduced risk of recurrence. They suffered less ankle sprains, has less loss of sport time due to ankle sprain, and therefore had reduced healthcare costs.
So the news is good. A structured rehabilitation program with a focus on balance/proprioception training can significantly reduce the risk of recurrence of ankle sprains.
What does the rehabilitation program involve?
The programme in the study prescribed three training sessions a week, with a maximum duration of 30 minutes a session.
The program included 4 variations of wobble board balance exercises, and 2 exercises for calf strength and ankle control. Subject were instructed in the correct technique for the exercises, and were provided with a wobble board to enable the bulk of the program to be carried out in their homes, thus reducing the cost of rehabilitation over the 8 week period.
As we said above, following the program lead to a significant reduction in recurrence.
Can you benefit from this program?
At oneBody Clinic, we use research such as this to shape our treatments and practice.
So if you have suffered an ankle sprain and are worried about recurrence, or if you have already had recurring ankle sprains, you can benefit.
If you are local to us, you can come and see us in the clinic, have your ankle fully assessed, and if it is right for you we will set you up on your own home-based ankle rehabilitation program.
If you need advice, but cannot get to us at OneBody, please still get in touch and we can work with you remotely to guide you through your ankle rehabilitation.
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