Welcome back to our three part blog series on lateral ankle sprains. In part 1, we discussed how these injuries occur. In part 2, we are looking at the initial management of lateral ankle sprains, including first aid protocols and when to come and visit a sports injury clinic such as seventy9 Sports Therapy, a leading sports therapy clinic in Guildford.
Part 2: Initial Management of a Lateral Ankle Sprain
When you experience a lateral ankle sprain, nailing the first week is crucial for creating a good environment for healing to take place. Here’s what you can do:
First Aid Protocols:
In recent years there has been a significant movement away from RICE protocols in acute injury management as we have found an increased need to move injured structures (within tissue and pain tolerance) and focus more on inflammatory fluid transfer over reduction in inflammation volume. Remember that two significant components of acute inflammatory fluid are proteins (for protein synthesis, i.e. tissue repair) and blood (hence the injury site/joint might look bruised). Our goal is not to stop inflammation entering the injury site completely, rather a combination of moderation of inflammatory flow in the first 48-72 hours followed by creating an environment where “old” inflammation is able to flush out of the space, therefore improve healing rates.
Rest (from aggravating activities): It is important to start moving the joint as soon as possible post injury, so long as the injured tissue is comfortable with this happening. You may be able to walk completely normally and pain free, or you may have to be on crutches in a non-weight bearing state with only gentle unloaded movement available for you. Whatever your level, it is important to not push this and create more irritation. An appointment at seventy9 Sports Therapy in Guildford as soon as possible post injury can help assess the ligament structures and guide what rest from aggravating injuries may look like for you.
Ice: Within the first 48-72 hours ice can be applied to the area. This helps to moderate inflammatory flow as well as acting as an analgesic. 10 minutes every hour is sufficient for tissue cooling and reducing the risk of ice burns. A bag of frozen peas/similar is perfectly adequate (don’t eat them afterwards!) and can be wrapped in a light tea towel to further reduce the risk of ice burns.
Hot/Cold: After the initial 48-72 hours, we would generally move patients to a hot/cold protocol as we attempt to start flushing inflammatory fluid through the joint. At seventy9 Sports Therapy in Guildford, we favour a protocol of 2 minutes hot, 1 minute cold, repeat 4 times (for a total of 12 minutes) every hour for lateral ankle sprains. Heat can be a hot water bottle or a bath at a slightly uncomfortable warm temperature (immersion method) and cold can again be a bag of frozen peas/similar.
Elevation: Elevation is an important tool in our arsenal for managing inflammatory flow, especially so with lateral ankle sprains given the effect of gravity. Inflammation has a real habit of sticking around with ankle and foot injuries and can significantly impact function. When we elevate an ankle injury, we only need to elevate it above hip height. Whilst this is often tricky to do during the day at work, as often as possible outside of that is suggested. Make sure to support the whole lower leg rather than just placing a pillow under the foot and leaving the knee exposed.
Seek Professional Help:
For effective and safe return to play rehabilitation programming it is essential to contact a sports therapy professional – such as our team at seventy9 Sports Therapy in Guildford – for a proper and thorough evaluation of the injury, regardless of how significant the suspected ligament damage is. Remember, rest is not an intervention! Early assessment and intervention can both promote good and effective healing, as well as guiding a safe return to play/function.
At seventy9 Sports Therapy in Guildford we can assess lateral ankle sprains within the first 48-72 hours as well as those that have been “rested” for a few weeks. Our primary goal is to assess the extent of the damage to the ligament, allowing us to create a timeline framework for return to play/function and script the initial injury management and rehabilitation protocol for the first week or two. Importantly, whilst early intervention is key to stopping this return to play schedule sliding to the right, if you are three weeks post lateral ankle sprain we still want to see you!
In part 3 of our series, we will provide five tips for rehabilitating sprained ankles. Effective rehabilitation is crucial for regaining strength and stability, returning effectively to pre-injury levels of exercise/sport/daily function and preventing future injuries.
Stay tuned for part 3!