Ankle injuries are common, with ‘inversion’ injuries being the main method of injury; the foot turns in due to increased pressure, load or uneven ground surface etc. Pain around the ankle and into the foot is generally experienced, with tenderness often centred around or just to the front of the ankle bone on the outside of the foot. This is because, on injury, the extra stress is placed on the ligaments in this area of the foot. Bruising in this area and swelling in the foot is often experienced.
Initial treatment as outlined in the Acute Injuries information is useful for management of ankle sprains. If weight cannot be placed on the ankle, with development of swelling and/or bruising immediately or within 1-2 hours of injury, then medical assessment should be sought to determine the presence of a fracture or more severe ligament injury.
It is important with ankle injuries to try and put weight through the ankle as able, in what is known as ‘optimal loading’. If weight can be put through the foot to walk then this should be maintained as able and increased as pain reduces until you are walking normally again. Often, due to insufficient rehabilitation post-injury, or a return to sporting activity too soon, the ankle is at higher risk of injury for up to two years.
Physiotherapy intervention for ankle injury focuses on healing of affected structures in the ankle, such as the tendons affected by the injury; exercises to regain range of movement at the ankle; strengthening of the musculature around the foot/ankle and return to sport.
General exercises for ankle injuries:
- Paddling the feet: keeping the feet moving helps encourage circulation of blood and reduction of swelling, so moving the feet up and down/in and out when sitting with feet up and knees straight can help with this.
- Single Leg Stance: as pain reduces and you are able to put normal weight through the foot then standing onto this foot is helpful to strengthen the small muscles in the foot to help prevent re-occurrence of the injury
- Calf Stretches: with reduced movement at the ankle the Calf muscles often tighten, causing tightness and pain down the back of the leg when the toes are pulled up. Maintaining the length of these muscles will allow for a more seamless return to sport once the ankle injury has healed. Calf stretches and use of a foam roller to work out tight spots, or trigger points, in the musculature are advised during this period of rehabilitation (and are helpful to maintain the length of these muscles year round, outside periods of injury).