Physiotherapy Treatment of Injury Series – Sprained Ankles

Sprained ankles are incredibly common and repeated sprains can lead to a swollen, agonizing ankle, problems walking on rough ground and the risk of re-injury. The physiotherapist commences with requesting: How did the damage occur? Was there a high level of pressure involved? What happened later – could the patient walk or did they go to hospital? Was there an x-ray? Oakville Physiotherapy

Just how badly the joint has been damaged is suggested by the amount of pain suffered following the harm. Very high pain levels or pain which will not steadily reduce are bad signs and the physiotherapist may ask for a review in the event of a break or severe ligament personal injury. Where the ankle has been injured can be deduced from the internet site of pain and confirmed on later testing by the physio. 

Special questions are asked about the earlier health background and prior injuries, any drugs the patient is taking, their appetite level, whether they are losing weight, their sleep quality and pain in the morning, their bladder and bowel normality and any relevant family history and ancestors. This is to clear the patient of any serious underlying condition so that treatment can be safely performed.

How Physiotherapists examine a sprained ankle joint

Movements of the ankle joint noted up on your bed without weight putting are dorsiflexion (pulling the ankle up), plantarflexion (pointing the foot down), eversion (turning the foot outwards), and inversion (turning the sole of the feet inwards toward the other foot). The movements inform the therapist about the willingness of the patient to move in the occurrence of pain and anxiety and limited actions give important information about the joint.

Testing of the ankle muscles by hand is completed by the physio to test any calf muscle damage, usually on the bed or standing up, progressing to passive assessment. The physio stretches the ankle gently in each direction to check injury to the joint structures, moving forward to palpating all round the joint to indicate which structure is damaged.

Treatment protocols for Physiotherapy

Physiotherapy treatment starts off with PRICE, which is short for protection, rest, ice, compression and elevation. Protection requires by using a brace to prevent abnormal movement of the joint and further destruction. Rest is important for damaged structures and allows the part to negotiate without stress. Cryotherapy or cold/ice treatment is useful to reduce pain and swelling.

The physio may use manual remedy for joint stiffness or pain and this allows the physiotherapist to increase the joint gliding movements and allow more normal joint technicians. This reduces joint rigidity, loosens in the joint and eases pain, allowing weight bearing exercises to start. Static exercises are being used primarily whilst holding on, moving on to active exercises without support.

The brain watches ankle position all the time, instructing muscle to contract to prevent harmful positions. Rehab involves controlling on one leg, advancing to standing on a wobble board and then throwing and catching a ball. Balance and skill retraining occurs until the ankle is good on rough ground and heading. The ankle has restored when pain has subsided, movements are good, power has returned and the proprioception or sense of joint position has recently been restored.

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