Ankle sprains are common injuries that happen when the ligaments that surround the ankle joint are ripped or stretched, usually as a result of abrupt twisting, rolling, or turning motions. Physical activity like running, leaping, or playing sports like basketball, soccer, or hiking are common causes of this kind of injury.

There are three grades of ankle sprains, based on the severity of the injury:

Grade I (Mild): This involves slight stretching or microscopic tearing of the ligaments. Symptoms may include mild pain, swelling, and stiffness.

Grade II (Moderate): This involves partial tearing of the ligament, leading to more significant pain, swelling, bruising, and difficulty moving the ankle.

Grade III (Severe): This is a complete tear of the ligament, causing severe pain, swelling, instability in the joint, and a lack of ability to bear weight on the affected ankle.

The symptoms of an ankle sprain can vary depending on the severity of the injury (Grade I, II, or III). However, the most common symptoms include:

• Pain
• Swelling
• Bruising
• Tenderness
• Stiffness
• Instability
• Difficulty in walking
• Increased temperature

Causes of ankle sprain

Ankle Twisting or Rolling: When the foot twists or rolls outside of its natural range of motion, it can result in an ankle sprain, which is one of the most frequent causes. This usually occurs during actions like running, jumping, or abrupt pivots that include quick direction changes.

Uneven Surfaces: Ankle sprains can result when walking, running, or exercising on uneven surfaces such as sidewalks, rocky walkways, or trails. Ankle sprains can occur from stepping off the curb or into a hole.

Sports & Physical Activities: Ankle sprains are frequently caused by sports that include jumping, abrupt pauses, direction changes, or high-impact motions (such as basketball, soccer, tennis, and volleyball).

Inappropriate Footwear: Ankle sprains can be more likely to occur while wearing shoes that are too small or don’t offer enough support. The ankle may twist or roll more easily if you’re wearing high heels, flip-flops or shoes with insufficient arch support.

Overuse: The ligaments may become more susceptible to sprains if the ankle is subjected to repetitive stress from overuse, particularly when jogging or dancing.

Weak or Unbalanced Muscles: The ankle may not have the support it needs to withstand the strains if the muscles that surround it are weak or unbalanced. This may make spraining the ankle during strenuous activity more likely.

Prior Injuries: Because the ligaments may not be as strong or stable as they once were, people who have previously suffered an ankle sprain are more likely to sustain another one.

Not enough Warm-up: If you don’t warm up correctly before doing out, your muscles and ligaments will become stiff and more vulnerable to injury. Exercises for warming up the muscles improve blood flow and flexibility, reducing the risk of sprains and strains.

Exhaustion: Muscle exhaustion increases the risk of a sprain because it may prevent the muscles from supporting the joint adequately. Additionally, fatigued muscles may react more slowly to abrupt motions or direction changes.

what happens if you don’t treat your ankle sprain

If an ankle sprain is not treated properly, it can lead to several complications that may affect both the short-term and long-term health of the ankle. Here are some potential consequences of not treating an ankle sprain:

• Chronic Pain and Swelling
• Increased Risk of Recurrent Sprains
• Chronic Ankle Instability
• Decreased Range of Motion
• Arthritis and Joint Damage
• Longer Healing Time
• Muscle Weakness
• Compensatory Injuries
• Increased Risk of Fracture

How to prevent your ankle sprain

• Wear Proper Footwear
• Strengthen the Ankle Muscles
• Stretch and Warm-Up
• Avoid Walking or Running on Uneven Surfaces
• Improve Your Technique
• Strengthen Your Core and Lower Body
• Use Ankle Supports or Braces (When Necessary)

Exercises to strengthen ankle

Ankle Circles

How to do it:

• Sit on a chair or lie down with your leg extended.
• Lift one foot off the ground and rotate it in a circular motion, first clockwise and then counterclockwise.
• Perform 10-15 circles in each direction for each foot.

Benefits: Improves ankle mobility and strengthens the ligaments around the ankle.

Calf Raises

How to do it:

• Stand with your feet shoulder-width apart, near a wall or chair for balance.
• Slowly rise onto the balls of your feet, lifting your heels off the ground.
• Hold for a second at the top, then lower your heels back to the ground slowly.
• Perform 3 sets of 10-15 reps.

Benefits: Strengthens the calf muscles (gastrocnemius and soleus), which are crucial for ankle stability.

Toe and Heel Walking
How to do it:

• Walk across the room on your toes, then walk back on your heels.
• Keep your movements slow and controlled.
• Perform 2-3 sets of 10-15 steps each.

Benefits: Improves balance and strengthens both the front and back muscles of the lower leg, enhancing overall ankle stability.

Resistance Band Exercises

How to do it:

• Dorsiflexion: Sit with your legs extended and wrap a resistance band around the top of your foot. Hold the ends of the band and gently pull it toward you, flexing your foot.
• Plantarflexion: Secure the band to a stationary object and place the other end around the ball of your foot. Push your foot away from you, pointing your toes.
• Inversion: Secure the band to the side of your foot, and move your foot inward against the resistance of the band.
• Eversion: Secure the band to the inside of your foot and move your foot outward.

Benefits: Targets all ankle movements and strengthens the muscles around the ankle using resistance for greater force and stability.

Single-Leg Stands

How to do it:

• Stand on one foot and maintain your balance. Try to hold the position for 30 seconds to 1 minute.
• For added challenge, do this with your eyes closed or while standing on an unstable surface like a cushion or balance pad.
• Repeat on each foot.

Benefits: Improves balance, proprioception (body awareness), and ankle stability.

Towel Scrunches

How to do it:

• Sit in a chair with your feet flat on the floor and place a towel in front of you.
• Using only your toes, try to scrunch the towel toward you.
• Repeat for 10-15 reps, and you can add a small weight on the towel for extra resistance.

Benefits: Strengthens the smaller muscles in your feet and ankles, improving overall flexibility and stability.

Ankle Alphabet

How to do it:

• Sit down with one leg extended straight in front of you.
• Using your big toe, “write” the letters of the alphabet in the air, making each letter as large as possible.
• Perform for 1-2 minutes for each ankle.

Benefits: Increases ankle mobility, flexibility, and strength in the surrounding muscles.

Lateral Leg Raises

How to do it:

• Lie on one side with your legs stacked on top of each other.
• Keeping your leg straight, slowly lift your top leg toward the ceiling, hold for a second, then lower it back down.
• Perform 10-15 reps on each side for 2-3 sets.

Benefits: Strengthens the muscles along the outside of the ankle and lower leg, promoting better stability.

Step-Ups

How to do it:

• Stand in front of a low step or platform (6–8 inches high).
• Step up with one foot, bringing the other foot up to join it.
• Step down with one foot, followed by the other, to return to the starting position.
• Repeat for 10-15 reps on each leg.

Benefits: Strengthens the calf muscles, quadriceps, and stabilizes the ankle joint.

Box Jumps (for advanced strength)

How to do it:

• Stand in front of a low box or platform.
• Bend your knees slightly and jump with both feet onto the box, landing softly.
• Step down and repeat for 10-15 reps.

Benefits: Builds ankle strength, stability, and explosiveness, helping to improve jumping ability and reduce injury risk.

When to see a doctor

While many ankle sprains can be managed at home with rest, ice, compression, and elevation (R.I.C.E), there are certain signs that may indicate a more severe injury that requires a doctor’s evaluation. Here are some key situations when you should see a doctor:

Severe Pain or Inability to Walk

If you experience intense pain, particularly when trying to bear weight on the injured ankle, it could indicate a more serious sprain or even a fracture. If you’re unable to walk or put any weight on the ankle, it’s a good idea to see a doctor for an evaluation.

Significant Swelling and Bruising

If the swelling is severe and doesn’t improve after applying ice and elevating the ankle, or if you notice significant bruising that spreads rapidly, it may suggest a more serious injury that needs medical attention.

Inability to Move the Ankle

If you have difficulty moving the ankle, or if you cannot rotate it in different directions, it could be a sign of a serious sprain, ligament tear, or even a fracture. A doctor can assess your range of motion and determine the extent of the injury.

Deformity or Abnormal Shape

If you notice that your ankle looks deformed, twisted, or out of place (e.g., your foot is pointed in an unusual direction), it could indicate a bone fracture or dislocation. This requires immediate medical attention.

Numbness or Tingling

If you experience numbness, tingling, or a feeling of weakness in the injured ankle or foot, it may suggest nerve involvement or damage to the ligaments and tissues, requiring medical evaluation.

Pain that Worsens Over Time

If the pain does not improve with standard self-care measures, such as rest, ice, compression, and elevation, and if it continues to get worse over time, this could indicate a more severe injury that may require medical treatment.

You Suspect a Fracture

If you suspect that you may have fractured a bone in your ankle (due to high impact, a fall from height, or direct trauma), you should see a doctor right away. X-rays or other imaging tests may be necessary to rule out a fracture.

Previous Ankle Injuries

If you have had prior ankle injuries and the current sprain feels different (more severe or persistent) or you’re worried about long-term instability, it’s a good idea to consult with a doctor to assess the injury and get proper treatment.

Infection Signs (after injury)

If the injured ankle shows signs of infection, such as increased redness, warmth, or discharge (especially if the injury has broken the skin), seek immediate medical care. Infections can complicate the healing process.

Failure to Heal

If after a few weeks of rest and rehabilitation, the ankle still hurts or shows no signs of improvement, this could suggest chronic instability or long-term ligament damage. A doctor can help develop a more comprehensive treatment plan or recommend physical therapy.

Risk factors and complications

Previous Ankle Injuries:

If you’ve had a previous ankle sprain, you’re at a higher risk of re-injuring the same ankle. The ligaments may be weaker or less stable after an injury, making them more susceptible to future sprains.

Sports and Physical Activities:

Participation in sports like basketball, soccer, running, volleyball, and tennis increases the risk of ankle sprains due to activities involving jumping, quick pivots, changes in direction, and high-impact movements.

Improper Footwear:

Wearing shoes that don’t offer enough ankle support, such as high heels, sandals, or poorly fitted athletic shoes, increases the risk of ankle sprains. Shoes that don’t fit properly or lack arch support can cause instability during physical activity.

Weak or Imbalanced Muscles:

Weak muscles around the ankle, particularly the calf muscles, can increase the risk of sprains because they provide less support during movement. Imbalance between muscle groups, such as weak outer or inner ankle muscles, can also make the joint more vulnerable.

Poor Balance and Coordination:

People with poor balance or coordination are more likely to experience ankle sprains because their bodies may not react quickly enough to sudden movements or changes in direction, increasing the risk of the ankle rolling or twisting.

Age:

Both younger people, particularly active children and teenagers, and older adults are at increased risk. Younger individuals may engage in more high-risk physical activities, while older adults may experience decreased strength, flexibility, and balance, making them more prone to ankle sprains.

Environmental Factors:

Uneven surfaces, such as trails, rocky paths, or slippery roads, increase the likelihood of ankle injuries. For example, stepping into a pothole or tripping on an uneven sidewalk can cause an ankle to twist.

Previous Health Conditions:

Conditions like joint hypermobility (increased joint flexibility), arthritis, or other musculoskeletal disorders can increase the risk of ankle sprains because they can affect joint stability or flexibility.

Complications of an Untreated or Severe Ankle Sprain

If an ankle sprain is not treated properly, it can lead to several complications. These complications can affect both the short-term recovery and long-term health of the ankle joint. Some possible complications include:

Chronic Ankle Instability:

If the ligaments don’t heal properly or if they are repeatedly injured, it can result in chronic ankle instability. This condition makes the ankle prone to recurring sprains and causes the joint to feel weak or unstable, even during normal activities.

Post-Traumatic Arthritis:

Untreated or severe ankle sprains can lead to joint damage over time, potentially resulting in arthritis. The constant wear and tear on the joint from improper healing can cause the cartilage in the ankle to break down, leading to pain, stiffness, and swelling.

Persistent Pain and Swelling:

If not adequately treated, pain and swelling may persist for months or even years. This can affect daily activities like walking, standing, or exercising and lead to a decreased quality of life.

Tendon Injuries:

A sprained ankle may also cause damage to the tendons surrounding the joint, such as the Achilles tendon. Tendon injuries can make the recovery process longer and more complicated, requiring additional treatment and rehabilitation.

Fractures:

In some cases, an ankle sprain can be severe enough to cause a fracture in the bones of the ankle or foot. A fracture requires different treatment than a sprain, and untreated fractures can lead to long-term complications like improper bone healing or deformities.

Muscle Weakness:

Without proper rehabilitation, the muscles around the injured ankle may weaken due to disuse or improper loading during recovery. This can contribute to further instability and increase the risk of re-injury.

Blood Clots:

In rare cases, a severe injury like an ankle sprain may increase the risk of developing blood clots, especially if the injured person remains immobile for a prolonged period. Blood clots can be dangerous and require immediate medical attention.

Nerve Damage:

Although rare, severe ankle sprains can lead to nerve damage in the ankle area, especially if there is significant swelling or bruising. Nerve damage may cause numbness, tingling, or weakness in the foot and ankle.

Infection:

If the skin is broken as a result of a sprain, an infection could develop. Signs of infection include increased redness, warmth, swelling, fever, or pus. Infection can delay healing and may require medical treatment.

Decreased Range of Motion:

If the sprain is not treated properly, the ankle may not regain its full range of motion. This can lead to stiffness in the joint and difficulty performing everyday activities, such as walking, running, or climbing stairs.

Preventing Complications

To prevent complications, it’s important to follow proper treatment for an ankle sprain:

• Rest and avoid activities that stress the injured ankle.
• Ice the ankle to reduce swelling.
• Compression to control swelling.
• Elevation to help reduce swelling.
• Rehabilitation exercises to strengthen and improve the range of motion once the acute phase has passed.

If symptoms persist or worsen, it’s crucial to seek medical attention for a thorough evaluation and treatment plan. Timely intervention and proper rehabilitation can help reduce the risk of long-term complications and ensure a full recovery.

How does physiotherapy helps in treating the Ankle Sprain

Physiotherapy plays a crucial role in the treatment and rehabilitation of an ankle sprain. The goal of physiotherapy is to restore the ankle’s function, strength, flexibility, and stability while reducing pain and preventing future injuries. Here’s how physiotherapy helps in treating an ankle sprain:

Pain Relief and Inflammation Reduction

• Manual Therapy: Physiotherapists use hands-on techniques such as soft tissue massage or joint mobilization to reduce swelling, improve circulation, and relieve pain. This helps reduce the acute discomfort from the sprain.
• Modalities: Various modalities like ice therapy (cryotherapy), heat therapy, ultrasound, or electrical stimulation (e.g., TENS) may be used to manage pain and inflammation in the early stages of healing.

Restoring Range of Motion

• Stretching Exercises: Physiotherapists guide patients through gentle stretching exercises to restore the full range of motion (ROM) in the ankle. After a sprain, the ankle can become stiff, and stretching helps improve flexibility in the ligaments, tendons, and muscles surrounding the ankle.
• Joint Mobilization: In some cases, physiotherapists perform joint mobilizations to improve ankle movement and help with stiffness. These passive movements also promote fluid circulation within the joint and facilitate healing.

Strengthening the Ankle Muscles

• Targeted Strengthening Exercises: After the initial healing phase, physiotherapists design strengthening exercises to target the muscles around the ankle, such as the calf, tibialis anterior (front of the lower leg), and peroneal muscles. Strong muscles support the ankle joint, reducing the risk of future sprains.
• Functional Strengthening: Physiotherapy involves exercises that mimic real-life activities and improve strength in movements specific to your daily routine or sport, such as balancing on one foot, jumping, or lateral movements.

Improving Balance and Stability

• Proprioception Training: Physiotherapists focus on improving proprioception, which is the body’s awareness of its position in space. This is crucial for ankle sprains because proprioception can be significantly impaired after an injury. Exercises such as standing on one leg, using balance boards, or doing exercises on unstable surfaces (e.g., foam pads) help restore this sense of balance and prevent future sprains.
• Core and Lower Limb Stability: Strengthening not just the ankle but also the hip and core muscles enhances overall stability, improving your ability to move safely and with less risk of injury.

Preventing Future Injuries

• Education on Injury Prevention: Physiotherapists educate patients on how to prevent future ankle injuries. This can include advice on proper footwear, warm-up and cool-down techniques, and strategies for safely returning to sports or physical activities.
• Customized Rehabilitation Programs: The physiotherapist can design a personalized
  rehabilitation program that addresses your specific needs, including your physical activity level, any pre-existing conditions, or previous injuries. This individualized approach ensures that your recovery is optimized and reduces the likelihood of re-injury.

Taping and Bracing

• Ankle Taping: In some cases, physiotherapists may use athletic tape to provide additional support to the ankle during the rehabilitation process, especially when returning to physical activity. Taping techniques help stabilize the joint while allowing mobility and preventing excessive movement that might lead to re-injury.
• Bracing: For individuals who are at high risk of further sprains, physiotherapists might recommend using an ankle brace for added support during physical activity. Bracing helps protect the ligaments while they heal.

Gradual Return to Activity

• Progressive Exercise Program: As your ankle improves, physiotherapists guide you through a progressive exercise program that gradually increases in intensity. This ensures that the ankle is strong enough and the joint is stable enough for you to safely return to your regular activities or sports without the risk of re-injury.
• Sport-Specific Training: For athletes or those involved in specific sports, physiotherapists often incorporate sport-specific drills and movements into rehabilitation to ensure you’re able to return to your activity at full capacity. This may include agility drills, hopping, or running exercises tailored to your sport.

Reducing Long-Term Complications

• Chronic Ankle Instability: Without proper rehabilitation, an ankle sprain can lead to chronic ankle instability. Physiotherapy focuses on restoring balance, strength, and proprioception to avoid long-term issues like instability, weakness, and recurrent sprains.
• Preventing Post-Traumatic Arthritis: Physiotherapy can help reduce the risk of long-term complications like post-traumatic arthritis by ensuring the ankle joint is properly rehabilitated. Physiotherapists work to improve joint mobility and reduce stiffness, preventing the joint from becoming too stiff or inflamed over time.

How SenOcare helps

SenOcare helps in providing physiotherapists, which can help in the rehabilitation of the client.