An ankle sprain is a stretch or a tear of the ligaments (bands of tiss - PDF document

An ankle sprain is a stretch or a tear of the ligaments (bands of tissue that hold bones together) supporting the ankle joint. Most ankle sprains result from the ankle turning inwards during an activity. This can be caused by a fall, a sudden twist, or landing on the side of the foot. The severity of the ankle sprain can vary. Grade IAn over stretch of the ligamentMinimal swelling and bruising around the anklePain with ankle movementAble to put weight on the foot, butmay limpWith appropriate exercises, itcantakeabout 2 weeks before returning to activitiesGrade IIA partial tear of the ligamentModerate swelling around the ankle. Some bruising may appear within acouple of daysPain and difculty moving the ankleDifcult to put weight on the foot; mayneed crutches for a few daysWith appropriate exercises, it can take 3–6 weeks before returning toactivitiesGrade IIIA complete tear of the ligamentSignicant swelling and bruising aroundthe anklePain and unable to move the ankleDifcult to put weight on the foot; willneed crutches for a few weeksWith appropriate exercises, it can take2–3 months before returningtoactivitiesLigament 514-412-4400, ext. 23310 2300Tupper street, C-831,Montreal (Quebec)H3H 1P3Ankle Sprain SEVERITY OF AN ANKLE It is important to reduce the pain from the onset. The RICE method is an effective mode oftreatment estReduce regular exercise and activities. Avoid activities that cause pain, swelling and discomfort. Use crutches until you canwalk without limping.Cold reduces pain and swelling. Applyice (example: crushed ice in a wet towel, a bag of frozen vegetables or a cold pack) and wrap it around the injured ankle witha towel or elastic bandage for15–20minutes. Repeat every 2–3hours during the day andafter exercising the ankle.ompressionIn order to help reduce swelling, wrap the ankle with an elastic bandage as shown in the Ankle Sprain Support and Compressionbrochure. Do not apply it too tightly. Wrap the ankle during the day. Remove it for exercises and before going to bed. Continue this wrapping pattern until the swelling is completely gone.levationGravity helps reduce swelling by draining excess uid. Elevate the ankle above the heart when lying down. Elevate the ankle on pillows when sitting on the couch orchair.herapeutic exercises are an important part of the treatment of an ankle sprain. hese exercises will promote recovery and help prevent re-injury and/or chronic problems. hysiotherapy exercises are the best way to: improve strengthimprove exibilityretrain balancereturn to full activity TREATNG A NED ANKLE hase 1RCIS Sitting or lyingSlowly move the ankle up and down, and side to sideRepeat each movement 20 timesSitting with the injured leg outstretched in frontPlace a towel around the ball of thefootAs you gently pull the towel towards you, push your foot downwards into the towelHold 5 seconds. Repeat 10 timesSitting with the injured leg outstretched in frontPlace a towel around the ball ofthefootPull the towel towards the body Feelthe stretch in the calfHold 30 seconds. Relax the footRepeat 2 timesSitting or lyingSlowly rotate the ankle in big circlesRepeat 20 times in each direction fter 24 hours, begin this exercise program. xercises are to be done barefoot. orassistance with these exercises or for further evaluation andtreatment, consult a physiotherapistpply ice and compression for 15–20 minutes after completingtheexercises 2 1 3 4 Sitting or lyingDraw the alphabet with the injured foot using the big toe as a pointer. Makethe letters as big as possibleSitting on a chairPlace a towel on the oor in front ofyouPlace the ball of the injured foot on oneend of the towelPlace a light weight (1-3 lbs) at the opposite end of the towelPull the weight with the injured foot while keeping your heel on the ground until the weight reaches the footRepeat 3 times in each directionStanding, hold onto the back of a chair forbalanceSlowly, rise up onto toes,keep knees straightHold 3 seconds,slowly come down onto heelsGradually shift more weight onto theinjured leg as you go upDo 3 sets of 10 repetitionsProgress to going up and down on the injured leg onlyFurther progress this exercise to walking on toes the length of a room (~10m) forwards and backwardsRepeat 5 times hase 2RCIS When the pain has diminished and you are able to stand on your foot, begin these exercises 1 time per day. xercises are to be done barefoot 2 1 3 StandingPlace hands on a wallPlace injured leg behind, keep knee straight and toes facing forwardPlace non-injured leg in front, bendkneeLean hips towards the wallFeel the stretch in the back of your injured legHold 30 secondsRepeat 2 timesStand on injured foot and hold position for 1 minuteProgress by throwing and catching aball against the wall while standing oninjured foot for 1 minuteFurther progress by standing oninjured foot and hold position for 30seconds with your eyes closed hase 2RCIS fter completing the exercises, apply ice and compression for 15-20 minutesIf there is no improvement within a week (example: decreased pain and swelling, improved ankle motion, walking without assistance) seek further medical attention 4 5 rogressive return to sports after an ankle sprain is recommended when:You no longer have pain or swellingYour injured ankle has full movement justlike the other sideThe strength in your injured ankle feelsas if it is similar to the other side (test this with rising onto your toes 10timeson each side)You are able to stand on the injured leg without difculty for 10 secondsYou are able to walk without limpingollow these gradual steps:Step 1a.Begin walking or jogging on aat surface forwards and backwardsStep 1Progress to jogging in zigzags and gure 8s. When possible try to jog on more difcult surfaces such as sand, grass or in waterStep 1c.When able to perform steps 1a and1b without any pain or swelling progress to hopping on one legStep 2.When you are able to tolerate hopping on 1 leg 5 times without any pain or swelling you may begin full practice with your team. An appropriate ankle brace or taping may be used initially when returning to practice. Braces are useful in reducing instability during the rehabilitation phase, but should be slowly phased out as the ankle stability increasesStep 3.Once you are able to complete a full practice with your team, without pain or swelling, you may return to full competition hase 3RCISOTE © 2012 MCH Trauma. All rights reserved.