Physical Therapy: How one wrong step can lead to long-term problems

The swelling of an ankle sprain seems to take forever to go away and often your ankle never quite feels the same.

One of the most common injuries out there is an ankle sprain.

I’m sure almost everyone at some point in their lives has taken that one wrong step and has felt the ‘pop’ and pain that comes with turning your ankle. The swelling in the ankle after an injury seems to take forever to go away and often your ankle never quite feels the same or in the very least can cause nagging problems for months.

In this column I am going to explain the steps you can take to avoid suffering long-term after that one wrong step.

A number of years ago the common response to treating ankle sprains was to put the ankle in a cast for four to six weeks. If someone twisted (sprained) their ankle the thought process was that we needed to keep the ankle from moving so that the injured ligaments could heal properly.

Unfortunately what happened to the ankle with this type of treatment was that it would become extremely stiff and weak. This stiffness and weakness would take months to recover from so medical professionals began to think that there must be a better way of dealing with such a common injury.

Fast forward to the present and instead of putting someone in a cast we have gone to the opposite end of the spectrum and many people who have an ankle sprain are told not to seek therapy but instead to ‘walk it off’—with the idea that getting back to normal as quickly as possible is the answer.

This strategy will work with minor sprains where you can put weight on your foot right away and where there is very minimal swelling. The more pain and swelling in your ankle and the less comfortable it is to put weight on after an injury, the more serious the sprain.

Unfortunately with more serious ankle sprains time does not heal all, and if left untreated you have a very real chance of suffering from long term issues including repetitive sprains and ongoing tendonitis. In fact, one study that followed people who had suffered a more serious sprain actually found that two years later, over half of the people in the study still complained of significant limits with their ankle.

So what should you do if you have a more serious ankle sprain?

Firstly, it is usually a good idea to visit your medical doctor to see if an X-ray of your ankle is needed. After ensuring you have not broken anything, it is important for the first two to three weeks to avoid re-injuring your ankle.

Don’t just sit around at home on the couch though, as getting movement in the ankle early on is extremely important in speeding up recovery. Early movement (within the first few days) helps to prevent stiffness, decrease swelling and limit muscle weakening. Putting weight on your ankle (as long as it causes only mild pain) as early as possible is also important. Using an ankle brace can help to put weight through the ankle and is often a better option than using crutches. Weight bearing will ‘wake up’ the muscles thus limiting weakening.

Remember to also follow the acronym RICE: Rest (protect your ankle but make sure to start moving it), Ice (15 minutes two to three times/day during the first week), Compression (tensor bandages work well) and Elevation (make sure your ankle is above the level of your heart).

Decreasing the swelling as quickly as possible is very important in order to get back the strength and movement.

After the first seven to 10 days of following these tips it is then a good idea to see a health care professional specializing in these injuries in order to ensure that you are doing everything you can to get your ankle back to normal as quickly as possible.

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