Remember the ICC Men’s Cricket World Cup 2023?
During the India vs Bangladesh match, Hardik Pandya had to leave the game due to an ankle twist. A Grade I sprain cost him the opportunity to play the remaining series.
What was the key factor that helped him get back on his feet and into the game, both literally and figuratively? Physiotherapy!
But ankle injuries aren’t limited to sports players. Whether running to reach the office on time, chasing a goal, rushing downstairs, or slipping, you can sprain your ankle anytime, anywhere!
What is an ankle sprain?
An ankle sprain is an injury associated with the stretching or tearing of ligaments in the ankle joint. Lateral ankle sprains are the most common type and occur when the ankle rolls outward, and the foot turns inward.
Ankle sprain classification:
Grade I – Stretching of the ligament
Grade II – Partial tear of the ligament
Grade III – Complete tear of the ligament
Clinical Presentation:
Pain, especially during weight-bearing
Swelling and bruising around the ankle joint
Reduced mobility in the ankle joint
Difficulty walking
Causes
Foot anatomy: Ankle sprains are more common in people with high arches or flat feet.
History of previous sprains: Prior episodes of sprains and ankle instability contribute to recurrent sprains.
Ligament laxity: Recurrent sprains can loosen ligaments, leading to increased susceptibility to sprains.
Improper footwear: Ill-fitted shoes, flimsy sandals, and high heels increase the risk of ankle sprains.
Type of sport: Indoor and court sports like basketball and tennis, as well as running sports like football, pose a high risk due to running and pivoting.
Overuse: Performing high-impact activities without proper warm-up increases the risk of ankle sprains.
Recovery and Healing
How can we manage an ankle sprain? Give it some PEACE and LOVE, a new approach with a better response rate than the traditional RICE method (Rest, Ice, Compression, and Elevation).
Immediate care: PEACE
P – Protection: Avoid aggravating movements for 1–3 days; continue with daily activities that aren’t painful.
E – Elevation: Elevate the injured leg above heart level to reduce swelling.
A – Avoid anti-inflammatories: Avoid anti-inflammatory medicines like NSAIDs or ice, as they may interfere with long-term tissue healing. While ice helps relieve pain, it may hamper the natural healing process.
C – Compression: Use elastic or compression bandages to reduce swelling.
E – Education: Educate the patient about the injury and the recovery process. Patients should be encouraged to perform active exercises and reduce dependence on passive techniques.
Long-term recovery: LOVE
L – Load: Gradually introduce weight-bearing movements to load the ankle joint and stimulate healing. Use canes or crutches if necessary.
O – Optimism: Maintain a positive mindset to aid recovery.
V – Vascularization: Perform pain-free aerobic exercises.
E – Exercise: Restore mobility, strength, and balance.
Exercise Breakdown
Range of motion exercises:
Start with gentle, non-weight-bearing ankle movements in a pain-free range, gradually progressing to weight-bearing exercises.
Strengthening exercises:
Use weight cuffs or resistance bands to strengthen intrinsic foot musculature, calves, and tibial muscles.
Aerobic exercises (4–6 weeks post-injury):
Swimming or hydrotherapy
Stationary biking
Balance training and proprioception:
Use audio, visual, and tactile cues for balance training.
Progress from stable surfaces to unstable surfaces with multi-directional movements.
Include stability training using reach-outs and perturbations.
Return to Sport Training
Agility drills
Sport-specific training
Plyometrics: High-impact exercises to improve physical strength and performance, like single-leg hops and long jumps
Preventive Strategies
Warm-up: Perform an adequate warm-up before games or workouts.
Appropriate footwear: Avoid high heels and wear supportive shoes with good ankle support.
Strength and balance training: Prevent chronic ankle instability and recurrence of sprains.
Ankle bracing or taping: Reduce the risk of re-injury.
Lifestyle modifications: Adjust training routines with rest periods and ensure adequate hydration to reduce the risk of overuse injuries.
Physiotherapy not only helps you move better but also strengthens your ankles like never before.
So, what’s stopping you from treating your sprain? Don’t you want to explore hidden trails and navigate difficult roads in life with better stability?
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