Ankle Sprains Part 2 - Management
In part 1 we spoke about what an ankle sprain is, how it happens, and when we should investigate to see if a fracture has occurred. Let’s now assume that you’ve got the all clear - there’s no fracture, but you do have some pain, swelling and difficulty moving your ankle because of the sprain. Below we’ve outlined a simple summary of how we can best manage an ankle sprain.
Immediate Management (1-2 weeks) - POLICE
If you’ve sprained or twisted a joint before, you may have been told to follow PRICE - Protect, Rest, Ice, Compress and Elevate. This has been the standard for managing acute injuries like ankle sprains for decades. However, recent research tells us that completely resting an ankle sprain isn’t ideal for recovery. In fact, light exercise can speed up the recovery process and help to return to function quicker. This is why the POLICE approach is now recommended - it’s identical to PRICE but replaces ‘Rest’ with ‘Optimal Loading’, which means light, gentle exercise that feels relatively comfortable for your ankle. This might include light walking, swimming or gentle ankle movements throughout the day.
Further Management (2+ weeks) - Exercise Rehabilitation
Once 2 weeks have passed, it’s likely that most swelling, redness and pain will have alleviated, but you won’t necessarily feel like your ankle is back at 100%. Walking may still feel uncomfortable, while more challenging tasks like climbing stairs or returning to sport don’t seem realistic yet. What can you do to get back to these activities?
As your ankle ligaments help with stability, balance and function of your ankle, issues relating to this may persist if your ankle isn’t managed correctly. This is where a specific exercise program is critical in regaining a high functioning ankle. Evidence shows that exercise programs involving balance and strengthening help to improve ankle stability and facilitate quicker return to sport or work. Whether you are an elite rugby player or a teacher who is on their feet all day, an exercise program will play a crucial role in returning you to pre-injury function.
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