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Ankle Pain

Ankle sprain, twisted ankle – whatever you call it, read about ankles here.

The ankle is a very complicated joint, and ankle sprains and injuries are more common than you might think.

Pretty much every child sprains their ankle at least once, but as we get older, sprains can take much longer to heal and need proper rehabilitation for a fully, speedy recovery. Although this page shouldn’t be substituted for hands on medical advice, here’s some information about the ankle and ankle sprains, what you should do if you’ve sprained your ankle and what we at State 11 Soft Tissue Therapy can do to help speed your recovery from this potentially long term injury.

What is an ankle sprain?

An ankle sprain is a stretch or tear in one or more of the outside (the medical term for this is “lateral”) ligaments of the ankle. Ankle ligaments are slightly elastic bands of tissue that keep the ankle bones in place. Since the ankle is responsible for both weight-bearing and mobility, it is particularly susceptible to injury. The relatively small joint has to withstand large forces exerted when walking, running and jumping, especially if the surface is uneven. Most ankle sprains happen when the ankle twists or rolls suddenly, usually a rapid and uncontrolled movement. The most common injuries happen when the foot rolls onto the outside of the ankle, straining the outside ligaments of the ankle joint. Symptoms of a sprained ankle include; pain, tenderness and swelling, bruising, trouble moving the ankle, and sometimes an inability to put your full weight on the ankle.

A woman in running clothing sat on the ground holding her ankle in pain

How long will my ankle sprain take to heal?

Most people recover completely from mild sprains within two to six weeks. More severe sprains can take up to six months before you can return to full activity, or sport. Once a significant sprain occurs, without good rehabilitation the joint may never be as strong as it was before the injury. It is not surprising therefore that many people have a history of repeated ankle sprains. With the correct rehabilitation however, you can help your ankle become even stronger than it was before the injury.

What to do if you have sprained your ankle

Tissue injury usually involves damage to small blood vessels that results in bleeding at the site of injury. This bleeding leads to inflammation, part of the natural healing process. However, the body tends to overreact to sudden traumatic injury and as a result excess inflammatory fluid accumulates which can result in ‘scar’ tissue production. Too much scar tissue may prevent normal function with reduced flexibility and increased risk of re-injury. It is important to get medical advice to gain a positive diagnosis and correct treatment.

If you suspect you have sprained your ankle, you might wish to visit your GP or local A&E department to check that you haven’t suffered a fracture or a break to one of the bones as the symptoms can be very similar for the first day or two.

Once you know it’s not a break or fracture, you should follow the PRICE guidelines immediately after injury and for at least 3 days afterwards before doing anything else. We can give you advice about this, just get in touch at info@state11.co.uk or call us on 07788 287098.

The PRICE guidelines say that you should protect, rest, ice and elevate the affected area, although the use of ice can be problematic as we’ll see below.

Protecting your ankle means that you should protect your ankle from undue stress – so no trampolining! You should try and avoid moving your ankle in the same direction as the sprain occurred.

Resting your ankle means not carrying out too much activity. We don’t recommend complete rest and immobility as this can slow recovery (this is known as “active rest” and it’s important to make sure you don’t put too much stress or weight through the joint). Icing your ankle is common advice.

Icing or numbing the ankle can reduce pain and swelling, and it’s suggested that you should apply ice for around five to ten minutes on bony areas every few hours whilst awake. However, we at State 11 advise minimal use of ice if possible; the most up to date research into icing injuries shows that it can slow recovery because the inflammation – the swelling – is necessary as the body tries to rush blood and healing cells to the area. Icing can also cause damage to muscle cells, so it needs to be an individual choice between a faster, but potentially more painful healing period or a slower, less painful healing period.

Compression is also common advice, and many people achieve this using a compression bandage. This should only be done whilst the foot isn’t elevated, and only for the first seventy-two hours. It shouldn’t cause pins and needles or any loss of feeling – if it does, it’s too tight! In our studio, we would look to use Rock Tape (a kinesiology tape) which is supportive, offers pain relief through neurological feedback but also allows some movement. Rock Tape can also help reduce swelling (lessening the need for both icing and the next common piece of advice, elevation).

Elevating the ankle is generally suggested because it reduces the flow of blood, which in turn reduces swelling. However, as mentioned, you need blood flow to the area, and you definitely don’t want to be reducing the blood flow to the damaged ligaments, as this can slow healing. Once again, it is a personal choice between speed of healing and discomfort or swelling.

Once the first few days have past, your ankle sprain is out of the “acute” phase and into the “sub acute” phase. This is when mobilisation and movement work can be started by a trained soft tissue therapist. This could include work both above and below the site of the sprain. This is because following a sprain, your body may try and “cope” with the injury by moving muscles in your leg and foot differently to compensate for the the injury. This phase of treatment is crucial to ensure you return to full function and prevent future injury.

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