Treatment and Rehabilitation Protocol for Acute Ankle Sprain

Even something as common as a slightly sprained ankle requires therapy. Nearly every athlete or active person will at some point need physical therapy (PT), which is the rehabilitation of an injury. Don’t shake your head. It doesn’t have to be a major injury, such as a broken bone. Even something as common as a slightly sprained ankle requires therapy. Ankle Sprains are among the most common in the lower limbs. It is usually caused by a low-velocity trauma such as twisting injuries, falls, car accidents and injuries related to sports activities.

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For our purposes, let’s follow the timeline of a sprained ankle without PT. You first realize something is wrong with your ankle after an activity. You felt a sharp pain when it happened, but the pain didn’t go away. Instead, your ankle became swollen and painful when touched. You iced it and spent a day or so inactive rest. Then you returned to your active life.

The ankle grew more painful as you kept walking and playing your sport, and it hurt every time you put weight on it. You naturally began to favor the injured ankle to prevent pain, transferring more work to the healthy ankle. This caused an imbalance in the way you shifted your weight. The imbalance quickly because chronic, affecting your entire active and athletic performance.

A physical therapist would have identified the imbalance in the way you walked and given you exercises and a program to follow that would help prevent favoring the sore ankle. The therapist would schedule more visits to keep track of how you were recovering, analyzing not only the ankle but the distribution of your weight. Some therapists have a pressure plate that measures the weight of each foot placement, showing whether you are doing less work on one side of the body.

Without this professional analysis and correction, you may continue letting one side of your body do more work than the other side. The results of such a change will eventually affect not only your walk but all activities. Your athletic performance will subtly decline over time, and you will always wonder why.

This timeline is common with any injury, whether it’s a broken bone or a pulled muscle, tendon or ligament. Having Physical Therapy, where you are observed and analyzed in your movement, is usually the solution to lingering effects of even a mild injury; not to mention a serious one.

If you have been smart enough to get Physical Therapy after a problem, never second-guess the therapist. If he or she tells you to ice it twice a day, do it. If there is a rehab program assigned by the therapist for homework, follow it as scheduled Regularly.

What Should Someone Do After an Ankle Injury?

You can apply Basic first aid for an ankle injury by remembering R.I.C.E: rest, ice, compression, elevation. these are basic Treatment concept which can vary accordingly.

1. Rest. It's important to rest the ankle to prevent further damage and keep weight off of it.
2. Ice. Using ice will help slow or reduce the swelling and provide a numbing sensation that will ease the pain. Proper icing includes icing within 48 hours of an injury, never leave ice on for longer than 15 minutes to 20 minutes at a time to prevent frostbite. Wait 40 minutes to 45 minutes before applying ice again to allow tissues to return to normal temperature and sensation, and repeat as needed. You can apply an ice compress using a plastic freezer bag filled with ice cubes and water to mold to your ankle or use a frozen bag of veggies like corn or peas, (don't eat them after you use them and refreeze them), use a layer of towel between your skin and the plastic bag.
3. Compression. Wrapping the injured ankle with an elastic bandage or off-the-shelf compression wrap will help keep it immobile and supported. Be sure not to wrap the ankle too tightly. If your toes that turn blue, get cold or lose sensation the wrap is too tight.
4. Elevate. Elevating the injured ankle to at least the level of your heart will reduce swelling and pain.

It is important not to put any weight on the ankle until after it's been evaluated by a doctor, which should be done as soon as possible. Fractures and sprains that are ignored or aren't treated properly can lead to long-term chronic problems with the ankle, such as repeated injury, ankle weakness, and arthritis.

How Does the Doctor Diagnose an Ankle Injury?

The first thing a doctor will do is ask questions about how the injury occurred. Then the doctor will examine the ankle, noting the amount of swelling and bruising. The physical examination of the ankle may be painful because the doctor needs to move the ankle to evaluate the pain and swelling in order to make a proper diagnosis.

The doctor may order an ankle X-ray to determine whether there are any broken bones. In addition to an ankle X-ray, your doctor may ask for X-rays of the leg and foot to determine whether there may be other related injuries. If the doctor suspects a stress fracture, the doctor will ask for other imaging scans such as an MRI, which will show more detail about the injury. If there is a fracture, the doctor may also ask for a stress test, which is a special X-ray taken with pressure applied to the joint. This will help the doctor determine whether surgery is needed.

For most ankle injuries, pain is controlled by using an over-the-counter medication such as acetaminophen or another nonsteroidal anti-inflammatory drug such as ibuprofen. The specific treatment of the injury depends on the type of injury.

Now comes the big problem: if you don’t have insurance that covers this kind of treatment, how are you going to pay for it? Be upfront with the issue. If necessary, tell the therapist that you will be paying out of pocket and will need to arrange an installment plan, if that’s the case. Most PT companies will do more than let you pay over time; they will often give you a break on the price of each visit.