By Jaclyn Kissel
Sport Specialist Chiropractor
Lateral ankle sprains are one of the most common injuries occurring in sports.
Soccer players are at an increased risk due to the nature of the sport incorporating running, kicking, quick changes of direction, and playing surface.
Grading a Sprain
There are 3 Grades of ankle sprain, which depends on the amount of damage sustained in the ligament of your ankle.
Conservative therapy/treatment and rehabilitation NEEDS to start right away, even with Grade 1 sprains. The goal is to prevent recurrence and to build the strength and balance around your ankle. Injured muscle, tendon and ligaments heal with stronger and more organized collagen fibril architecture when a gentle load is applied during the healing process. Chiropractors or physiotherapists are great health care providers that will guide you in the right direction in regards to your treatment plan.
Rehabilitation of your ankle should be done in a step wise manner. The program should start with non-weight bearing exercises, moving to resisted exercises, and then weight bearing activities. Of course no two injuries are the same and your health care provider will be gearing the rehab based on their assessment. The basic components of a rehab program are as follows; PRICE, range of motion (ROM), Strengthening, Proprioceptive exercises and functional exercises.
Initial treatment methods — or P.R.I.C.E. — include:
Restoring Range of Motion
Functional ankle rehabilitation starts by normalizing joint ROM. This involves gentle movements of your ankle, taking care to avoid causing further tissue stretch injury. This aspect of healing can be performed by you with at home exercises and further enhanced in clinic by your chiropractor or physiotherapist. For example, performing gentle ankle pumps or drawing out the Alphabet with your foot to encourage movement. As symptoms allow, you can begin to progress to weight-bearing exercises.
Resistance exercises can begin when there is no pain through the available range of motion, with full weight bearing. Rehabilitation programmes usually start with low-level strengthening such as holding a sustained contraction. From there you can progress to exercises using a Theraband. See below for some examples of exercises. Once you are have reached pain free motion doing these exercises you can progress to body weight exercises.
Proprioceptive / Balance Exercises
Retraining your proprioceptive/balance system is an integral part of sprain rehabilitation and is often forgotten. Sustaining an ankle sprain leads to significant deficits in balance. Ankle disc training (wobble board) has been found to significantly improve balance testing and decrease symptoms of functional instability. Proprioceptive training has also been shown to reduce the rate of re-injury in ankle sprains. Some examples of exercises are listed below
Functional/Sport Specific Exercises
The final phase of acute ankle sprain rehabilitation consists of functional exercises and sport-specific drills. These may begin when there is full ankle range of motion, no pain, and about 80% strength compared to the other ankle. These exercises help the athlete re-learn sport specific motor patterns. The patient should start at a low level of intensity and progress with increased intensity and difficulty provided they remain pain free while performing the exercise, and have no pain or swelling following the training session. In terms of soccer you can do drills that involve weaving in and out around pylons, skipping, kicking drills, and running with changing directions.
Treatment and rehabilitation of ankle sprains is important to speed up recovery and help avoid recurrence. Your chiropractor or physiotherapist have many options to assist with your healing and get you back to your sport healthy and strong.