The Foot and Ankle Clinic

Ankle sprain

What is an ankle sprain?   |  The ankle ligaments injured by an ankle sprain  |  What else can be injured?   |  What symptoms might I have with an ankle sprain?   |  How common is a sprained ankle?  |   What is the difference between an ankle sprain and an ankle ligament rupture?   |  What treatments are available for a sprained ankle?   |  Which is the best treatment for an ankle sprain?   |   What sort of ankle brace to use for an ankle sprain?   |  Functional rehabilitation after ankle sprain   |  What is the expected natural history after an ankle sprain?  what if it doesn't get better?  When would an operation be appropriate?   |  What operations are available to stabilise the ankle?   |   Does the ankle ever "give" the other way (the foot facing outwards, rather than inwards)

 

Treatment of Ankle Sprain

There are four ways available to manage an ankle ligament sprain/rupture. These are either to do nothing and simply wait for the ankle to settle. Secondly, to immobilise the injured ankle in a plaster cast for a period of 4-6 weeks, walking as comfortable. Thirdly, to use functional rehabilitation to treat the sprained ankle (a graded physiotherapy programme, often combined with a removable ankle brace). The final option is to operatively repair the injured ligaments.

Aircast airsport brace

The Aircast airsport brace

Which is the Best Treatment for an Ankle Sprain?

It is generally accepted that following an ankle sprain the results of functional rehabilitation are better than no treatment or simple plaster cast immobilisation. Better in terms of recovery following ankle sprain means a quick return to sports and work and less swelling and instability. Surgical treatment may produce the best recovery of all, though any evidence of this is divided.

What Sort of Ankle Brace to Use for an Ankle Sprain?

There are numerous types of ankle braces available to help with recovery following an ankle sprain. All are removable devices which support the ankle externally and mechanically stabilise the ankle and sub-talar joints. These can be worn just for activities which give a problem following ankle sprain or as part of a post-operative rehabilitation programme.

aircast ankle stirrup

aircast ankle stirrup

aircast ankle stirrup


 

Functional Rehabilitation After Ankle Sprain

Functional rehabilitation is generally a physiotherapy supervised programme. The specifics will vary but there are three phases of treatment. The first phase of treatment after an ankle sprain is to rest, elevate and ice the ankle. If available, an Aircast cryo cuff can be of use in this phase and non-steroidals (such as Brufen or Voltatrol) may be of use if these are not contraindicated. Once swelling is sufficiently reduced to allow it a removable ankle brace may be used. Once the acute phase of bruising and swelling after an ankle sprain settles (usually 1-2 weeks) the second phase of rehabilitation begins. This entails supervised gym work aimed at maintaining/improving ankle movement and also increasing strength and stability from the peroneal muscles. A removable ankle brace is often helpful during this phase during treatment. Once fully comfortable weight bearing is possible and some strength and stability has returned to the ankle joint, rehabilitation can progress to a more taxing phase with a wobble board and isometric training. Once this is comfortable and the ankle feels stable then stamina training and reintroduction to sporting activities can begin.

wobble board

A "wobble board" in use.

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