What should you do if you suffer a Sprained Ankle?
In the first few days following an ankle sprain it is important to follow the RICE protocol - rest, ice, compression and elevation (never apply ice directly to the skin). An Ankle Cryo/Cuff is the most effective method of providing ice therapy and is the professional's choice. A Cryo/Cuff is ideal for home use as it is the safest and most effective method of ice therapy. It can provide continuous ice cold water and compression for 6 hours and significantly reduce ankle pain and swelling. Alternatively if you have to apply ice at home, the use of an Ice Bag is recommended. This is a safe method of ice application to avoid the risk of an ice burn. Alternatively, use an ice pack or bag of frozen peas but make sure that the ice is kept form the skin by a few sheets of kitchen roll or a tea-towel.
Rehabilitation (video) significantly improves the level of ankle function. Wobble board training in the later rehab stage is designed to assist the re-education of the proprioceptive system. Previous research has suggested that patients with ankle instability who underwent wobble board training experienced significantly fewer recurrent sprains during a follow-up period than those who did not follow the training programme.
Rest from sports is essential, but even walking on the ankle, if it is painful, may cause further damage and should be avoided. No weight should be put through the injured ankle and crutches should be used. Pain relieving medication prescribed by a doctor may be necessary.
Ice Packs are applied for periods of twenty minutes every couple of hours (never apply ice directly to the skin). The Ice Packs relieve pain and are thought to reduce bleeding in the damaged tissue. The Aircast Ankle Cryocuff is the most effective method of providing ice therapy and is the professional's choice. It can provide continuous ice cold water and compression for 6 hours – and significantly reduce pain and swelling.
A swollen ankle is a sign of a significant ankle sprain. The swelling is caused by bleeding in the tissue and a leaking of cellular fluid secondary to tissue damage. If this swelling is allowed to consolidate it can produce excessive scar tissue which seriously lengthens the rehab period. Compression during the early stages helps to resolve swelling and is essential for a good outcome. Compression is provided by the use of a Removable Plastic Cast which has inflatable air cells to massage out swelling, with intermittent use of an Aircast Ankle Cryocuff to provide ice and compression.
If the ankle is not elevated the effect of gravity causes the tissue fluid to accumulate at the ankle. This can cause increased tissue pressure which is extremely painful. To relieve pain and prevent excessive swelling, the ankle is elevated above waist height.
If the pain allows, the ankle should be removed from the Removable Plastic Cast and gently pumped forward and back 20 times each hour. This is done by sitting down with the leg elevated and pushing the toes forward and back. This facilitates the dispersal of swelling from the ankle. Electrotherapy treatments such as ultrasound and pulsed short wave diathermy are effective in speeding the healing process.
Often people coming in for treatment of a sprained ankle are suffering with repetitive injuries which are causing weakened ankle ligaments and surrounding muscles and tendons. In this case, light frictions may be used although it is important to consider that the ligaments are already weak and you should be aiming to build up the strength in the muscles surrounding the joint. Muscle energy techniques can help to re-establish proprioception to prevent future injuries.
In the case of a 1st injury, treatment is important to prevent the injury happening again. Sports massage can help with flushing out the swelling in the joint, breaking down adhesions and stretching tight tissues such as the calf muscles.
By Mark Povey - Sports Massage Therapist