I’ve Injured My Ankle What Should I Do? – Managing Ankle Injuries
Ankles, we all have them and alike our bodies many other joints are not immune to pain and injury. In fact ankle pain and injury are one of the most common presentations seen by private practice physiotherapists. Luckily with comprehensive assessment, correct diagnosis and thorough rehabilitation you can return to the things you love pain and injury free. Through my own numerous ankle injuries I understand the impact an ankle injury can have, the need for a thorough rehabilitation programme to minimise chance of re-injury and what can happen if it isn’t done right. In today’s blog we explore what some of the common ankle injuries are, some keys to successful management and rehabilitation of ankle injuries to prevent reoccurrence.
The ankle joint is a composite joint (there’s two), the talocrural joint (formed by the tibia, fibula and talus) and subtalar (formed by the talus and calcaneus). This enables the multiple planes of movement at the ankle – up and down, rotation and movement in and out. Supporting the ankle are a number of ligaments, muscles and tendons, which when combined with nerves, bursas and joint surfaces create numerous structures capable of being injured or a source of pain. Additional in some instances pain in the ankle region can be referred from other structures such as the spine.
To determine the diagnosis a physiotherapist will complete a comprehensive assessment, which will include the history of the injury and how it occurred, any previous injuries and aggravating and easing factors. In addition your physiotherapist will also look at range of movements at the ankle, palpation of ankle structures, special tests of ankle ligaments, strength and balance. This enables accurate diagnosis and a pathway to recovery including addressing contributing factors that may increase rick of injury re-occurrence.
Common Ankle Injuries
- Lateral ankle sprains
- Medial ankle sprains
- Syndesmosis sprain (high ankle sprain)
- Tendon rupture or tendinopathy
It is important to note in the management of ankle injuries, that no two injuries are exactly the same. Each individual will have variations in management depending on the injury, severity, individual deficits, variations in biomechanics, contributing factors for reoccurrence and return to running, sport or high impact activities. Common components in the rehabilitation of ankle injuries include:
- Acute Pain Management
- Rest – a short period of relative unloading of the ankle joint
- Ice – pain relief and reduction of selling
- Compression – compressive bandaging, taping or a boot can provide additional support and aid in reducing ankle swelling and discomfort
- Elevation – elevation of the ankle assists to decrease swelling
- Range of Ankle Movement – this is vital for normal ankle functioning, from activities as simple as standing and walking to more complex tasks your ankle needs to be able to move through its normal ranges.
- Proprioception – proprioception is the body’s awareness of its position and its joints position in space, balance training (eg single leg balance and hops) is vital to redevelop proprioception in injured ligaments. POGO’s Galileo (Link) may assist proprioception and strength in the rehab process.
- Strength – restoring optimal strength to ankle ligaments and muscles. Commonly this involves use of resistive bands of increasing difficulty.
- Addressing contributing factors – this may include, but is not limited to strengthening and stretching muscles at the hip or knee, the use of orthotics and alteration of footwear. This is important in reducing risk of reoccurrence.
- Functional and sport specific training – whether you’re returning to work, running or sports with quick changes in direction (eg. netball, basketball, football), readying your ankle for these impacts and movements is an essential component in ankle rehabilitation and prolonging the health of your ankle. The use of ankle taping or bracing can also be very beneficial.
So don’t be like me and experience recurrent ankle injuries and pain, complete a thorough physiotherapy assessment and rehabilitation program. Let’s look after those ankles.
For more foot and ankle related insights click HERE.
Lewis Craig (APAM)