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 email@example.com 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.