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WRFL partner Physioplus will be sharing tips each month on how to cope with injuries, today we learn about Ankle Sprains.
Ankle Sprain: What should you do? Michael Freeman (Physio)
What should you do with an acute ankle sprain?
1. Rule out serious injury
2. Respect the healing process
3. Manage pain, manage swelling, optimise loading
4. Restore range of movement, control, function and strength
Ruling out serious injury
An important initial question for the primary care practitioner: 'Is it fractured?'. Kerhoffs et al. 2012 estimate that only around 15% of ankle sprains result in a fracture but it is important to rule this out. The Ottawa Rules are strongly recommended, but need to be applied appropriately.
Respecting the healing process
The body has amazing abilities to heal and though we may try to speed up this process, perhaps in reality all we can really do is try to create the best environment for healing to happen. Patients need to understand that time is essential.
Manage pain and swelling
RICE remains a standard recommendation, but a recent study in BJSM has recommended we update this to POLICE which stands for Protection Optimal Loading Ice Compression and Elevation. This study, while rather technical, explains why early loading may be very advantageous to healing. So we typically recommend moonboots, air stirrups or braces and partial weight bearing immediately. Typically this will speed return to activity or work. Yes, we stock a full range of ankle braces which can be fitted immediately on a walk-in basis at our clinics.
Restoring range, control and strength
Physiotherapists will typically be focussed on: restoring ankle range, improving muscle power, restoring balance, progressing control rehab, and finally returning to sport specific function and running. It is important that patient address impairments as they return to function - statisticaly ankle injuries have a very high recurrence rate. I am never surprised when a patient says "I've done this ankle before." This probably a reflection of inadequate rehabilitation the first time round.
Of course if you have an acute ankle sprain present we can see them immediately to fit a brace or support - referrals can be made by phone, walk-in, online or email.
Michael Freeman (Physiotherapist)
Michael is currently completing a Master in Sports Physiotherapy. He practices at our Whitten Oval (Footscray) clinic, referrals can be made here.