Everyone has had an ankle sprain, right? It’s no big deal, not worth having anyone look at it because it’s just going to take some time to get better on its own. Not so fast! Unfortunately, I don’t see as many ankle sprains as I think I should. People either never seek help from any healthcare provider, or they go to see their doctor who gives them a brace, maybe some crutches, and tells them to ice it and stay off of it for a while. That’s it, no instructions on when or how to return to activity.
This can set people up for re-injury or lingering pain. When we sustain an ankle sprain, we not only have damage to the ligaments. Sometimes during the healing process, the ankle joint stiffens up and loses some of its mobility. In addition to the ligamentous injury, we also damage the nerve endings that tell us where our bodies are in space (proprioception). This sets us up for an increased chance for injury in the future. In fact, research shows that you are at a higher risk for re-injury if you have a minor (low grade) ankle sprain compared to a severe (high grade) one. This is likely because people are more likely to be referred to physical therapy after a severe sprain and are more likely to just “walk it off” after a minor one.
The importance of physical therapy after an ankle sprain is threefold. We help instruct you how to take care of yourself in the acute stages. It’s not just as easy as rest and ice. Rest, ice, compression, and elevation (RICE) are important, but so is early return to gentle movement and controlled loading of the joint. The goal is to get the motion back as early as possible and get back to a normal walking pattern as soon as possible. Only a physical therapist can help you through this process and avoid either pushing yourself too hard, or not hard enough.
Second, and along the same lines, during the next few weeks we help people know how and when to progress themselves to the next step. An important part of this progression is a focus on balance and proprioception. We need to re-train those nerve endings and the body’s ability to tell where it is in space. This is crucial to getting people back to their activities with less risk of re-injury.
Lastly, we have a battery of tests that we put people through in order to determine if/when you are ready to return to your sport or activity. The tests we run people through depend on the activities required.
So next time you roll your ankle, don’t just “walk it off” and hope it goes away. Seek out treatment from a physical therapist. Your body will thank you for it!