This is a very common sporting and accidental injury which typically occurs when ‘rolling your ankle’ or ‘going over’ on it. This mechanism in which the foot folds under and your leg goes sideways causes damage to the ligaments on the outside region of the ankle – typically the anterior talo-fibular ligament (ATFL) and/or the calcaneo-fibular ligament (CFL).
A lateral ankle sprain (LAS) is usually graded on a scale of 1-3. A grade 1 injury is categorised as damage at a microscopic level without a stretch. Presentation usually involves minimal swelling and soreness and functional capacity being maintained. A grade 2 represents a tearing of the ligament but remains attached – this presents with a degree of swelling and pain coupled with reduced function and movement alongside instability. Finally, a grade 3 entails a complete rupture of the ligament and involves significant swelling, severe tenderness, reduced stability and functional loss.
Based on the mechanism of injury, symptom severity and clinical presentation when seen in clinic, your Physiotherapist will have the knowledge and experience to provide you with an accurate diagnosis. Your clinician will give you information on which grade of sprain you have sustained. Guided by your physical capability and what activities are important to you, we will work collaboratively with you to design a bespoke exercise and management programme with your goals as the main consideration.
Total rest and immobilisation is usually advised, however, we recommend the use of functional support – such as a brace, which has shown to produce better functional outcomes than immobilisation during the early phase following trauma.
Exercise rehabilitation forms the foundation of the treatment and recovery following LAS. The goals in the early stages of rehabilitation are to manage the swelling and work towards achieving full range of motion; beginning with gentle movement to maintain range and then gradually developing the movement. Alongside range of motion exercises, isometric holds can begin.
When >80% of range has been achieved, we can begin to strengthen through this available movement. This can be done using resistance bands and/or progressive weight bearing exercises. We are looking to strengthen pointing and bending of the ankle and lateral movements – most specifically the movement which is opposite to the mechanism of injury which is called eversion.
As range of motion improves and pain reduces, aim to walk as symmetrical as tolerable alongside progressively introducing more load/weight-bearing activity. Going forward, as strength, function and movement improves, exercises are progressed with increased resistance and complexity in line with symptoms before returning to activity/sport.
Please find the patient resources section of our website where we have created a series of recommended exercise programmes. To access these, please contact us to obtain the password. We advise consulting with your Physiotherapist prior to trying any of these exercises.
Your Physiotherapist at Pure may use soft tissue mobilisation and manual therapy techniques to help support your recovery by reducing pain and increasing the movement available.