Ankle sprains are one of the most common injuries, affecting athletes, weekend warriors, and anyone who missteps on uneven ground. Despite their prevalence, many people don’t fully understand how to treat and prevent ankle sprains, leading to prolonged recovery, re-injuring or spraining of the ankle, and other chronic issues. This blog post will help you understand the causes, treatment, and prevention of ankle sprains based on recent research and best practices.
What is an ankle sprain?
An ankle sprain occurs when the ligaments supporting the ankle joint are stretched or torn, usually due to excessive twisting or rolling of the ankle. The lateral ankle ligaments (on the outside of the joint) are most commonly affected.
There are three grades of sprains:
- Grade 1: mild stretching of the ligaments with minimal swelling.
- Grade 2: partial tearing of the ligament with moderate swelling and bruising.
- Grade 3: complete tear of the ligament, resulting in severe swelling and instability.
What causes ankle sprains?
According to research ankle sprains often occur during activities involving sudden changes in direction, landing on uneven surfaces, or overuse during repetitive activities.
Risk factors include:
- Weak ankle stability or previous sprains.
- Poor footwear, especially for athletes.
- Limited proprioception (body awareness) in the ankle joint.
The long-term impacts of ankle sprains
Chronic ankle instability is a common consequence of poorly managed ankle sprains. Chronic ankle instability can be the result of repeated injuries or insufficient rehabilitation, leading to reduced balance and strength, which increases the risk of future sprains. Research shows that a lack of neuromuscular training post-sprain often contributes to chronic ankle instability.
Treatment: best practices for recovery
Immediate care for ankle sprains focuses on the R.I.C.E. method:
- Rest: avoid activities that put stress on the ankle.
- Ice: apply cold therapy to reduce swelling.
- Compression: use bandages to limit swelling and provide support.
- Elevation: keep the ankle elevated to reduce fluid accumulation.
However, modern research suggests that early mobilisation is critical for recovery. Functional rehabilitation, including controlled movement and strength exercises, can significantly reduce recovery time and improve outcomes. A new acronym is becoming more widely used and accepted for these types of injuries, called P.E.A.C.E & L.O.V.E
- Protection: avoid activities and movement that increase pain during the first few days after injury.
- Elevation: elevate the injured limb higher than the heart as often as possible.
- Avoid anti-inflammatories: anti-inflammatories i.e. neurofen/voltaren reduce tissue healing. For this same reason, avoid icing the injury.
- Compression: use elastic bandage or taping to reduce swelling.
- Education: your body knows best. Avoid unnecessary passive treatment and medical investigations and let nature take its course.
&
- Load: let pain guide your gradual return to normal activities. Your body will tell you when it’s safe to increase the load.
- Optimism: condition your brain for optimal recovery by being confident and positive.
- Vascularisation: choose pain-free cardiovascular activities to increase blood flow to repair tissues.
- Exercise: restore mobility, strength and proprioception by adopting an active approach to recovery.z
Preventing Ankle Sprains
Preventative strategies focus on strengthening the ankle joint, improving proprioception, and wearing proper footwear. Evidence highlights the importance of neuromuscular training, including balance exercises, plyometrics, and dynamic stability drills.
Additional tips
- Use an ankle brace during high-risk activities.
- Incorporate exercises like single-leg balance drills, resistance band work, and agility training into your routine.
- Ensure proper warm-up before engaging in sports or physical activities.
Final Thoughts
Ankle sprains may seem minor, but they can lead to long-term issues without proper care. By understanding the causes, following evidence-based treatments, and incorporating preventive exercises, you can reduce your risk of injury and stay active.
If you’re dealing with an ankle sprain or chronic ankle instability, book in with one of our chiropractors and we can assist you with a personalised rehab plan.
References
- Allois, R., Niglia, A., Pernice, A., & Cuesta-Barriuso, R. (2021). Fascial therapy, strength exercises and taping in soccer players with recurrent ankle sprains: A randomized controlled trial. Journal of Bodywork and Movement Therapies, 27, 256–264. https://doi.org/10.1016/j.jbmt.2021.03.022
- Handoll, H. H., Rowe, B. H., Quinn, K. M., & de Bie, R. (2001). Interventions for preventing ankle ligament injuries. Cochrane Database of Systematic Reviews, 2001(3), CD000018. https://doi.org/10.1002/14651858.CD000018
- Dubois, B., & Esculier, J.-F. (2020). Soft-tissue injuries simply need PEACE and LOVE. British Journal of Sports Medicine, 54(2), 72–73. https://doi.org/10.1136/bjsports-2019-101253
- Verhagen, E. A., & Bay, K. (2010). Optimising ankle sprain prevention: A critical review and practical appraisal of the literature. British Journal of Sports Medicine, 44(15), 1082–1088. https://doi.org/10.1136/bjsm.2010.076406
- McKeon, P. O., & Wikstrom, E. A. (2016). Sensory-targeted ankle rehabilitation strategies for chronic ankle instability. Medicine and Science in Sports and Exercise, 48(5), 776–784. https://doi.org/10.1249/MSS.0000000000000840
- van Rijn, R. M., van Os, A. G., Bernsen, R. M., Luijsterburg, P. A., Koes, B. W., & Bierma-Zeinstra, S. M. (2008). What is the clinical course of acute ankle sprains? A systematic literature review. American Journal of Medicine, 121(4), 324–331.e6. https://doi.org/10.1016/j.amjmed.2007.11.018
- Kaminski, T. W., Hertel, J., Amendola, N., Docherty, C. L., Dolan, M. G., Hopkins, J. T., … & van der Wees, P. (2013). National Athletic Trainers’ Association position statement: Conservative management and prevention of ankle sprains in athletes. Journal of Athletic Training, 48(4), 528–545. https://doi.org/10.4085/1062-6050-48.4.02
