Ankle Sprains: Why RICE isn’t going to cut it for you…
by Jess Ackad
Ankle sprains are one of the most common injuries we see as physios – just about everyone has probably sprained their ankle at some point! And most people just ice it, maybe take some painkillers or use crutches for a few days, and elevate the swelling. And sure the majority feel better in a week or two, no worries… But this isn’t enough… Certain factors can put a person at greater risk of spraining their ankle including poor footwear, previous injury (did you know you are up to 70% more likely to re-sprain without correct post-injury rehabilitation?), reduced strength, poor biomechanics or poor balance receptors.
We know that the ligaments heal really well after a sprain, so we focus on the strength and function of the ankle after a sprain to help prevent re-injury down the track – as the ankle doesn’t automatically regain this on its own. Each ankle sprain is different, and having your ankle properly assessed lets you know what things you should be doing at each stage of your rehab, and how long it will take. Doing things that are appropriate for where your ankle is along its recovery helps the ligament heal, but also minimises excess scar tissue. Recovery time is different for all, but usually it usually takes approximately six weeks for the ligaments to heal fully. However there can be vastly different outcomes in terms of return to play depending on the severity of the injury, demands of sport/life activities, other mechanical issues (eg pre-existing strength and stability). This is where we as physios come in – appropriate rehab for your injury can significantly decrease ‘rehab’ time and speed up recovery leading to an earlier return to normal activity levels.
Despite what should be good and relatively short rehab and recovery times following ankle sprains, we regularly have people coming in months or even years post ankle sprain either with chronic re-injury or an ankle ht has just ‘never been the same. So why is it that some people have an excellent outcome and some have ongoing issues? A group of researchers looked at this very conundrum by following a group who sustained a simple lateral ankle sprain for twelve months. They found that when comparing those that had a full recovery with no ongoing symptoms with those who had chronic issues there were markedly changed gait patterns and joint ranges through gait. Now it can all get pretty technical from here, but the take home is that early and appropriate rehabilitation which addresses any areas of weakness or stiffness and ensures they are resolved are crucial in good long term outcomes for what seems to be an innocuous injury.
C. Doherty et al. Locomotive biomechanics in persons with chronic ankle instability and lateral ankle sprain copers. Journal of Science and Medicine in Sport 19 (2016):524-530.