Wellness Osteo

Wellness Osteo

At Wellness Osteo, we are osteopaths who focus on achieving optimal health and wellness, which means treating you and sharing our expertise with you. Read on for the ins and outs of osteopathy.

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Ankle Sprains

Ankle sprains occur when the ankle goes through an extreme range of motion that causes stretching of the ligaments in the foot. The most common sprain is an inversion sprain where your ankle rolls out to the side. The other type of sprain, an eversion sprain, is less common but can still occur. Ankle sprains are common in sports such as netball, football, basketball and soccer where there are a lot of changes in direction and landing on someone’s foot causing the ankle to roll to the side. They can also occur during walking or running if the surface is uneven or slippery. The most common ligament that is damaged in an ankle sprain is the ATFL ligament which is located on the top part of the outside of your ankle, the second most common ligament involved is the calcaneo fibular ligament which is located lower down on the outside of the foot.

Symptoms
There are 3 grades of an ankle sprain. All recovery times are general estimates and will depend on the severity of the sprain, compliance to rehab and if any other injuries were sustained.

 

Grade 1

This is usually referred to as a rolled ankle. This is when the ligaments have a small amount of microscopic tears but no decrease of ligament total strength.

Recovery time – Natural recovery time is 14 days. Return to sport or activities will vary between each person depending on the level of rehab completed and the level of pain. Usually 4-6 weeks is a general time to return to sport. Rehabilitation is important to return strength to the ankle and taping can be used initially for 2-4 weeks to help support the ankle. Long term use of taping isn’t beneficial as this delays strengthening of the ankle.
Symptoms-  Swelling and bruising can develop 3-4 days after the initial injury, pain on weight bearing that usually subside in 4-5 days. There may still be pain for roughly 2 weeks with certain movements of the ankle, but weight bearing usually isn’t painful. The ankle may feel stiff and have limited range of motion, this is why rehab is really important to get that ankle back moving how it used to.

 

Grade 2
When the ligaments are stretched and there is a macroscopic tears or a partial tear of the ligament.
Recovery time- Partial tears take longer to heal as there is a larger amount of healing to be done by the body. Usually this takes 6-8 weeks to return to sport or activity, depending on the width of the partial tear.
Symptoms- Pain, a clicking or popping sound during the time of the injury, inability to weight bear after 5 days, swelling and bruising are all common symptoms.


Grade 3
This is a complete tear of the ligament.
Recovery time- Recovery time is roughly 10-12 weeks and some cases may require surgery to help repair the ligaments.
Symptoms- Severe pain, large swelling, feeling of instability in the ankle and high tenderness to touch.

 

Treatment/Management

The PEACE and LOVE approach is a good tool to use after an ankle sprain or any other acute injury.

Protect- This is where we unload or restrict movement of the area for 1-3 days. This can be done by decreasing weight bearing on the ankle and any rapid movements. This decreases the risk of reaggravating the injury. During this time gentle movement such as ankle circles or ankle pumping within pain limits is beneficial. 

 

Elevate- Elevate the ankle higher than your heart as this will help remove built up fluid from the ankle.

 

Avoid anti-inflammatories- The inflammatory system of the body is necessary for healing, This is where the body is sending healing cells and nutrients to heal the damaged tissues. Using anti-inflammatories early on can disrupt this process and lead to decreased potential of healing. Painkillers such as panadol can be used to decrease pain as it doesn’t have any anti-inflammatory properties.
It is also suggested to avoid ice, there is varying evidence relating to the benefits of ice as it can potentially affect the healing process, but ice can still be used to help reduce swelling as evidence is varied it will not do a lot of harm so can be personal preference.

 

Compression- Compression is a great way to improve circulation and decrease swelling in the joint.

 

Education- Education about the injury is very important! There is a great deal of high quality evidence that supports an active approach to injury is more beneficial than a passive approach. This means that if you understand the injury, the expected healing times and how much movement you can do greatly improves recovery. 

 

These are all for the initial first days approximately 1-5 days depending on the degree of your injury. The next phase is LOVE.

 

Load- Loading your ankle through weight bearing within pain limits is great to start doing when your symptoms permit. Returning to normal tasks should start as soon as your symptoms allow. If it is a little sore with walking thats okay to try and do the tasks you normally do. If the pain beomes too much taking breaks between movement is perfect, as a little movement and weight bearing is better than none.

 

Optimism- It is so easy to get discouraged, angry or upset when we suffer an injury. Trying to remain positive, remembering that our injury will heal and we will get back to our sport or activity is an important way to assist with recovery.

 

Vascularisation and Exercise- Cardiovascular exercise will help increase blood flow to help with healing and improve movement in the ankle. Some low impact options would be walking, riding an exercise bike or swimming initially if it hurts to run. And on top of that general exercise and strengthening of the ankle such as calf raised and resisted eversion are great to help strengthen the muscles and ligaments of the ankle.

 

Manual therapy can be beneficial during all phases of recovery to help increase range of motion, improve circulation and increase strength via rehabilitation exercises prescribed.