Treating acute and chronic lateral ankle sprains

This post was written by Jithmie Jayawickrema, PT, Parkview Therapy Services.

Ankle sprains are a common complaint, affecting everyone, from competitive athletes to those performing everyday tasks. Despite the widespread nature of this injury, many underestimate the potential for long-term issues. Research published by the National Institutes of Health National Library of Medicine shows that up to 40% of ankle sprains result in chronic symptoms, with approximately 20% of individuals who sustain an acute sprain developing chronic ankle instability. In this post, we examine the symptoms, causes and treatment options for proper ankle recovery.
 

What is a lateral ankle sprain?

An ankle sprain is an injury to the ligaments, bands of tough elastic tissue surrounding the ankle. This connective tissue is essential for supporting joints and preventing excessive movement. When a twisting injury disrupts these ligaments, it can cause weakness, pain and instability.

The most common type of ankle sprain is an "inversion" injury, which occurs when the ankle/foot caves inward, damaging the outside of the joint. This area is also known as the anterior talofibular ligament, part of the lateral ligament complex.

Ankle sprains can be acute or chronic. When left unaddressed, recurrent injuries can lead to persistent ankle instability, which can progress to post-traumatic osteoarthritis.
 

What are the symptoms of a lateral ankle sprain

After a sudden twist of the ankle, patients often experience:

• Pain on the outside of ankle with tenderness to touch

• A feeling of instability when walking

• Swelling at the site

• Bruising

• Restricted range of motion

What are the causes of a lateral ankle sprain?

Ankle sprains can occur in various situations, but they usually result from the following scenarios:

• Falling in a way that causes the ankle to twist

• Walking, running or jumping on uneven surfaces

• A history of previous ankle sprains

Risk factors for lateral ankle sprains

Certain risk factors can increase the likelihood of experiencing an ankle sprain, such as:

• History of previous ankle injury

• Being female

• Asymmetrical ankle dorsiflexion range of motion

• Sports participation (soccer, basketball)

• Poor physical conditioning

• Ligament laxity

• Improper footwear

How can physical therapy help?

In most instances, ankle sprains can be treated at home using the RICE (rest, ice, compression and elevation) technique. However, depending on the severity of the twist, a more comprehensive approach may be necessary to prevent repeated injuries and chronic instability.

Treating acute and post-acute lateral ankle sprains in physical therapy may entail:

• Utilizing external supports like braces and taping to assist with and prepare for weight-bearing activities.  

• Therapeutic exercises focused on the ankle's active range of motion and strength.

• Neuro-muscular reeducation to improve balance and proprioception to assist with improving ankle stability

• Manual therapy

  • Lymphatic draining decreases swelling.

  • Soft tissue mobilization addresses soft tissue restrictions or tightness.

  • Ankle joint mobilizations improve ankle dorsiflexion (backward bending) range of motion, which is commonly lacking in patients who have sustained an ankle injury.

Incorporating daily stretching before and after physical activities and continuing physical therapy exercises several times a week following recovery helps maintain ankle strength and prevents further injury. Before returning to work or sports, individuals should consult their physical therapist to ensure full completion of their personalized return-to-activity program. For more information, or to schedule with one of our expert physical therapists at any of our locations, call 260-266-7400.