Ankle Sprain Treatment and Recovery

Mark: Hi, it's Mark from Top Local. I'm here with Adam Mann of Insync Physio in Vancouver, and we're talking physiotherapy, how are you doing today? 

Adam: Hey, Mark. Good to see you. I'm doing quite well. 

Mark: So you're going to tell me about an ankle injury today. What was going on with this person's ankle? 

Adam: Yeah, so this was a young professional, like a 20 year old and he just was getting into CrossFit. And his trainer was trying to get him to do some lateral hopping drills, basically a lateral lunge. So he was jumping pretty far off to the side and he tipped over and he kind of rolled his ankle sort of like this. And he heard a snap. And he could walk on it afterwards, but it got really swollen and it got pretty painful.

And so the next day he went down to the hospital and actually got an x-ray. He was pretty worried about it. They couldn't find a fracture. They told him it was a pretty bad ankle sprain and they referred him to physiotherapy. So he sort of waited a week thinking it might get better, but it really wasn't getting too much better.

Mark: So what did you do? He came in to see you, obviously, what did you do to assess it?

Adam:  So, basically we took a detailed history. I wanted to find out there's a lot of different ligaments in the foot and in the ankle. Some are more serious than others. So we took a history. We basically found out if this was the first time this has happened, if it's happened again. We looked at his walking pattern or his gate. We basically went in and we tested all the different ligaments. This sounds painful, but it actually, wasn't really painful at all. We found out which ligament was at fault and it was actually a ligament called the anterior talofibular ligament.

It's just an ankle on the side of the, the foot and it basically prevents your foot from moving too far forwards versus your shin bone. So it's quite a common injury. But because he heard a snap, he was pretty worried about it. So we also looked at the muscles around his hip and his knees to make sure that there weren't any contributing factors to the fall.

But basically the idea was that we figured out what the injury was and how we should treat it. So on assessment day, Really, what we tried to do is just figure out exactly what's going on, give a prognosis on how we can recover from it and give them some good exercises so that they can start the healing process.

The other thing we did as I taped his ankle, so I basically went in and helped just prevent any provocative motions on that ankle. And that was basically our assessment. 

Mark: So what was the course of treatment?

Adam: Ligaments can take a while they don't have a lot of blood supply. And the main thing is that this type of injury tends to get quite swollen. So a lot of the stuff we know, but we don't entirely know how it works. So basically swelling means that we have to elevate and we really want to make sure that there's more space inside the joint for the joint to move freely.

So the other thing, with treatment is we really want to limit the provocative motion. So if he rolled his ankle kind of like this, you want to avoid this motion initially. Once you get that under control, we are trying to actually strengthen the muscles on the outside and the inside of the ankle. And it's really hard to actually do this. We use the band and we use some pretty specific exercises to really work on that. The other thing I tell people is just elevation, elevation, elevation. So really making sure that that fluid has a place to drain to, so it can get out of the area. 

We do some soft tissue work. So we really get the muscles around the area to relax. We do some lymphatic massage, that sort of thing. And eventually we definitely start to add load onto it. So we start to strengthen the muscles all around the ankle. The other component I like to tell people is that we like to work on balance or joint sensors. So basically ligaments have really specific, processes where it tells your joint position. And that's really important for when you are jumping or running or doing anything like that. And these get injured when you have a ligament sprain. 

So what we do is we really do try to work on balance and proprioception, which is just basically another one word for body awareness. So we added in a couple of hopping drills once the pain levels were down and we worked on basically balance as well.

Mark: And how did it all work out for your patient? 

Adam: Well, he's running a half marathon in about a month from now. So he's doing quite well. Got him back to what he was doing. 

Mark: Another happy customer at Insync Physio. If you've got any kind of ankle problems, I've had this, I had this in basketball. This exact injury actually, and it was not treated very well and it's still pains me to this day. But if you want it looked after properly so that you never have this happening or reduce the odds of it happening substantially you want to use a physiotherapist who really understands how the body functions. And will take you through a course of treatment that's going to make you feel better and strengthen your body so that it can heal properly. Insync Physio. You can reach them at the website You can book right from there, or you can give them a call in Vancouver, (604) 566-9716 or in North Burnaby, (604) 298-4878. And ask for Adam, he'll help you out. Thanks, Adam. 

Adam: Alright. Thanks Mark. Have a good one.