Ankle sprain: symptoms, consequences and optimal rehabilitation

What is an ankle sprain?

Anankle sprain is an acute traumatic injury affecting the joint's lateral ligament complex. It results from excessive inversion of the hindfoot or a combination of plantar flexion and adduction of the foot. This injury often results in significant functional deficits and functional impotence.

What are the consequences of an ankle sprain?

A sprain can trigger what some specialists call the "catastrophic cascade":

• Initial sprain poorly managed.
• Recurrent sprain, defined as two or more injuries to the same ankle.
• Sensation of joint instability, felt in daily or sporting activities.

If left untreated, this chronic instability can develop into ankle osteoarthritis.

Why can an ankle sprain go wrong?

There are several reasons why some sprains do not progress well. Inadequate initial treatment, such as light rehabilitation or an unfocused clinical examination, can be the cause. Ignoring warning signs, or resuming activity too soon, can also lead to long-term complications.

What to do after an ankle sprain?

After a sprain, it's essential to follow the PEACE & LOVE protocol, which combines steps for the acute phase and the active rehabilitation phase.

The PEACE phase (immediate post-injury):

• Protection: Limit movement for the first few days to avoid aggravating the injury.
• Elevation: Keep the ankle elevated to reduce swelling.
• Avoid NSAIDs: Anti-inflammatory drugs can slow tissue healing.
• Compression: Apply a bandage to limit swelling and local bleeding.
• Education: Learn about load management and avoid unnecessary treatments.

The LOVE phase (progressive):

• Progressive loading: Resume suitable activity to stimulate healing.
• Optimism: Adopt a positive attitude to improve your chances of recovery.
• Vascularization: From day 3ᵉ, introduce pain-free cardiovascular exercise to increase blood flow.
• Active exercises: Promote functional rehabilitation through targeted, progressive movements.

What are the general guidelines after an ankle sprain?

For a Grade III sprain, immobilization should not exceed ten days. Thereafter, movement and weight-bearing should be resumed progressively, with the use of a semi-rigid splint to secure the joint. Active rehabilitation is essential, and includes neuromuscular and proprioceptive exercises. It's also important to work on overall strength, particularly in the hips and knees, while varying the types of exercise. Finally, don't hesitate to gradually increase the load to optimize your recovery.

How do you know if you're suffering from chronic ankle instability?

Signs of chronic instability include a history of repeated sprains, frequent sensations of instability or ankle "slippage". To confirm this diagnosis, validated questionnaires such as the Cumberland Ankle Instability Test (CAIT) or the Identification of Functional Ankle Instability (IdFAI) are used. A functional assessment of your ankle, using tools such as the FAAM, can also determine the impact on your daily activities and sports.

Why consult a specialized physiotherapist?

A physiotherapist will evaluate your situation through a thorough assessment that includes analysis of joint range, muscle strength and balance. Based on this data, he or she can propose a personalized rehabilitation plan designed to meet your specific needs.

Why is exercise so important after an ankle sprain?

The benefits of physical exercise have been widely proven by science. In the case of a sprain, they rapidly reduce swelling and pain, restore normal mobility, and promote a rapid return to daily activities and sports. In the long term, they reduce the risk of complications such as chronic instability, and offer excellent cost-effectiveness for patients.

When should you resume sport after a sprain?

Returning to sport should not be rushed. Before returning to sport, your physiotherapist will perform specific functional tests to assess the stability and functionality of your ankle. These tests are essential to ensure a safe return to sport and prevent the risk of relapse.

Make an appointment with Llum, our specialist physiotherapist at Réadaptation Charmilles

At Réadaptation Charmilles, our specialized physiotherapist will support you with a personalized approach to optimize your recovery. Make an appointment today to regain your mobility and confidence!

Article written by Llum,physiotherapist specializing in foot and ankle rehabilitation.