By MH Staff - Posted on 22nd January 2014
Ankle sprains are the most common acute injury in the world. If you’ve torn one or more of your ankle ligaments, find out how to reset it…
You’re tearing down the touchline, ball at your feet like CR7. You take on the final defender, with a perfect diski stepover. You go right, but your ankle ligaments go left – and you crumple to the ground. This injury is known as a twisted or rolled ankle, but whatever you call it, it’s a partial or complete tear of one or more of the ankle ligaments. “This is a joint and ligament problem that can occur in any running or jumping sport that includes change of direction and speed,” says Schwellnus. “It’s very common in sports like soccer, squash, basketball and rugby where there’s sudden changes in direction, with uneven surfaces increasing the risk.” The symptoms are pain, swelling, warmth and redness. The nerves become more sensitive, so you’ll feel pain when you put pressure on the area, the joint will become stiff and bruising will show. These injuries are classified as Grade 1, 2 or 3; depending on how much ligament damage there is. A Grade 3 is a complete tear.
Have you sprained your ankle before? By far the strongest risk factor, especially if the sprain has happened in the last 12 months. A study in the European Journal of Sport Science found a two- to five-fold increased risk for a lateral ankle ligament injury after suffering a prior ankle injury. Have you been playing sport regularly? If this is your first game after a long lay-off, then your injury risk increases drastically. Are you playing on an even surface? Holes, loose gravel, ditches or divots increase the risk. Do you warm-up properly before playing? If the answer is no, the risk shoots up. Aim to do at least five to 10 minutes of both dynamic and static stretches.
Don’t put any weight on the ankle. Immediately initiate the RICE procedure, which works well to minimise swelling. Don’t place ice directly on your ankle (wrap a dishcloth around the ice cubes), and apply it for intervals of five minutes on, one minute off. Repeat this sequence four to six times every six hours. If you hold the ice down for longer periods, it can actually make the swelling worse as it increases the circulation, according to the European Journal of Sport Science. If you use bandages to compress the injury, don’t make it so tight that it cuts off circulation. Avoid anti-inflammatories within the first 24 to 48 hours after the injury, but painkillers with paracetamol can help. Once the pain and swelling has reduced, you can start with some gentle cycling on a stationary bike. Still can’t put any weight on the ankle? That could mean a fracture. Go see a doctor.
Two words: balance training. “Ankle sprains are the most common acute injury in the world,” says Schwellnus. “The biggest cause of ankle sprain re-injury is because the ankle joint structure is not as secure as it was before the initial injury and neuromuscular control of the ankle is reduced.” When athletes return to sport before the ligaments have healed properly, they heal in a stretched position, making the ankle joint less stable. This can lead to a condition called Chronic Ankle Instability, which means you’ll be on a first-name basis with your physiotherapist. To prevent this, ankle proprioception is critical to keep the ankle in a safe neutral position, and this ability is often impaired after injury. Studies in the European Journal of Sport Science found that external support (like bracing and taping) can reduce the risk of re-injury in athletes with a history of ankle sprains, but not in athletes with no previous injury history. A cheaper, well-investigated and highly effective preventative measure is balance training. This kind of neuromuscular training is thought to improve proprioception by re-establishing and strengthening the protective reflexes of the ankle. Exercises on balance boards or mats can reduce the risk of ankle sprains by as much as 50%. Combine this with some plyometric work, and you’ll end up with super-stable ankles that’ll handle any sport. Ask your physiotherapist for examples of the exercises needed to improve your ankle proprioception.