Ankle Sprains: Comprehensive Guide to Diagnosis, Treatment, and Rehabilitation via Chiropractic

Hello, friends! We're seeing a surge in the number of ankle sprains walking into our clinic these days, and it's no surprise why. With our active lifestyles and unpredictable pavements, our ankles sometimes get the short end of the stick.
 

But don't worry! As your trusted partner in health, Ian The Chiro is here to help. In this post, we'll be breaking down everything you need to know about ankle sprains - from the what and how, right down to the chiropractic remedies.
 

What Are Ankle Sprains?

Ankle sprains occur when the ligaments around the ankle are stretched or torn beyond their usual limits. These ligaments are tough, fibrous tissues that connect the bones of our bodies, providing stability to our joints. Depending on the extent of the injury, sprains can range from a minor overstretching of a ligament to a severe, complete rupture.
 

How Do Ankle Sprains Happen?

Ankle sprains typically happen when the foot rolls inward too much, putting excessive stress on the ligaments on the outside of the ankle - what we call an inversion injury. This isn't always due to risky activities; it can be something as simple as walking on an uneven road or missing a step. But yes, the risk runs higher in physical activities that involve sudden direction changes or jumping, like futsal, basketball, or trail running.
 

Causes of Ankle Sprains

A significant majority of ankle sprains are the result of an inversion injury, where the foot rolls inward, causing excessive stress on the ligaments on the ankle's exterior. This can happen through seemingly innocuous everyday activities such as walking on uneven surfaces or missing a step. They're also a common injury in physical activities that involve running, jumping, or sudden changes in direction, such as football⚽, basketball🏀, and trail running🏃🏃‍♀️.

Participation in sports or physical activities often accounts for a high number of ankle sprains. The quick, high-intensity movements can lead to a misstep that results in an ankle sprain. Even wearing inappropriate or high-heeled shoes can contribute to ankle sprains, as they can lead to imbalance and instability, thus making the ankle more prone to rolling or twisting.
 

Understanding Risk Factors for Ankle Sprains

Certain factors can increase the likelihood of experiencing an ankle sprain. These include:
 

• Previous Ankle Injury: As highlighted by Herb and Hertel (2014), the greatest risk factor for recurrent ankle sprains is a history of previous sprains. Repeated lateral ankle sprains can lead to chronic ankle instability (CAI), characterised by altered postural control, sensorimotor deficits, reduced physical activity, functional limitations, and long-term joint degeneration, leading to further instability and health issues. This is particularly true if the ankle was not fully rehabilitated after the initial sprain.
   
• Physical Activity Level: Individuals who regularly participate in high-impact sports or activities involving jumping, running, or abrupt changes in direction are at increased risk.
   
• Environmental Factors: Uneven surfaces, or walking or running on slippery or loose terrain, can cause a foot to slip or twist, leading to a sprain.
   
• Footwear: Shoes that do not offer proper support or are inappropriate for the activity or terrain can increase the risk of an ankle sprain.
   
• Inadequate Warm-up: Not adequately warming up before physical activity can leave muscles and ligaments vulnerable to injury.
   

A recent study by Kulie et al. (2023) adds to our understanding of ankle sprain risk factors, revealing a strong association between obesity and ankle sprains. The study found that overweight individuals have almost double the risk of experiencing this injury due to the increased strain obesity places on the ankle ligaments. This emphasises the role of weight management in preventing ankle sprains and promoting joint health.
 

Recognizing Ankle Sprains: Symptoms

An ankle sprain will typically present with the following symptoms:
 

• Pain: Often immediate and localised around the affected ligaments, the pain can vary in intensity depending on the degree of the sprain.
   
• Swelling: This is a natural response to injury, as the body increases blood flow to the injured area to support recovery.
   
• Bruising: Bruises often appear shortly after the injury, resulting from ruptured capillaries beneath the skin.
   
• Limited Mobility: Difficulty moving the ankle, particularly in directions that stress the injured ligaments, is common.
   
• Instability: In severe cases, the ankle may feel unsteady when attempting to stand or walk.
   

If you've ever wondered, "Can you still walk with a sprained ankle?" The answer is that it largely depends on the sprain's severity. While it may be possible to walk with a minor sprain, a severe sprain can result in significant instability, making walking difficult and painful.

An Evidence-Based Chiropractic Approach to Ankle Sprains

Here at Ian The Chiro, we don't just tackle your ankle sprains. We blend the latest research, our hands-on experience, and a deep understanding of your unique situation and preferences to provide a comprehensive healing plan.
 

Comprehensive Diagnosis | Diagnosing Ankle Sprains

Accurate diagnosis is the foundation of effective treatment. We begin with a comprehensive history taking, followed by a physical examination that encompasses palpation, range of motion tests, and orthopaedic tests.
 

To further ensure the accuracy of our diagnosis, we incorporate a diagnostic tool known as the Ottawa Ankle Rules. This tool assists us in determining if imaging tests such as X-rays or an MRI are necessary, helping to avoid unnecessary radiation exposure and streamline your treatment plan.
 

One commonly asked question is, "How do you know if a sprained ankle is serious?" The severity of symptoms, coupled with the results from our physical and imaging tests, helps us gauge this. For example, intense pain, inability to bear weight on the ankle, or evidence of a potential fracture or severe ligament tear on an X-ray or MRI indicate a more serious sprain.
 

The Ottawa Ankle Rules: A Diagnostic Tool

These guidelines help healthcare providers discern when an X-ray is required for potential fractures after an ankle injury. They suggest an X-ray is necessary if there is pain in the malleolar or midfoot area, along with:
 

• Bone tenderness at the posterior edge or tip of the lateral or medial malleolus.
• Bone tenderness at the base of the fifth metatarsal or the navicular bone.
• An inability to bear weight both immediately after injury and in the emergency department for four steps.
   

Keep in mind, these rules are a guide and don't replace a comprehensive clinical evaluation.
 

Tailoring Your Treatment

With a solid diagnosis and understanding of your specific needs, we create a personalised treatment plan, typically involving:
 

• Manual Therapy: Specific chiropractic adjustments and manipulations to improve joint function, reduce inflammation, enhance circulation, and stimulate healing.
   
• Therapeutic Exercises: Custom exercises to strengthen your ankle and enhance flexibility. These exercises should be comprehensive and progressive, including range of motion, stretching, strengthening, neuromuscular, proprioceptive, and sport-specific exercises as indicated by research conducted by Halabchi and Hassabi (2020). Performing these at home can expedite recovery and lower the chances of re-injury.
   
• Use of Bracing: Based on the research, bracing has shown a high level of evidence in managing acute ankle sprains and should be considered as part of the treatment process.
   
• Education and Lifestyle Advice: We provide advice on modifying activities, enhancing workspace ergonomics, or adjusting exercise routines to prevent re-injury and promote optimal health. It's also important to be aware of common mistakes in the management of ankle sprains, such as excessive imaging, unwarranted non-weight-bearing, unjustified immobilisation, delay in functional movements, and inadequate rehabilitation.
   

Remember, an evidence-based algorithmic approach considering your individual characteristics is helpful and should be applied to your treatment.
 

Prognosis and Rehabilitation

Recovery timelines for an ankle sprain can vary based on the severity of the injury and individual's overall health. Many patients experience significant relief after just a few treatment sessions, but commitment to the treatment plan, including at-home exercises and lifestyle changes, is crucial.
 

So, "How long does a sprained ankle take to heal?" While it varies, minor sprains usually heal within a few weeks, whereas severe sprains could take several months.

To the question, "Can an ankle sprain be treated?" we confidently answer, yes. Beyond treating the immediate sprain, we focus on your ankle's rehabilitation and prevention of future sprains. This may involve balance training, sport-specific training, and advice on proper footwear to ensure your safe return to regular activities.

Final Thoughts

Ankle sprains can be a real pain, but remember, there's always a way out. And that's where chiropractic care comes in, backed by science and designed for your specific needs. At Ian The Chiro, we're not just about treating your symptoms. We aim to provide a comprehensive understanding of your condition, equip you with the tools to manage your symptoms, and empower you to take control of your health. So, if you're dealing with an ankle sprain or any form of chronic pain, remember - we're here to help. Contact us today, and let's walk (or hobble) together towards your recovery journey.
 

Remember, every step you take is a step towards better health!
 

Interactive Quiz: Test Your Knowledge on Ankle Sprains

Before we wrap up, let's do a quick quiz to test what you've learned from this comprehensive guide on ankle sprains.

Reference:

Halabchi, F., & Hassabi, M. (2020). Acute ankle sprain in athletes: Clinical aspects and algorithmic approach. World Journal of Orthopedics, 11(12), 534-558. https://doi.org/10.5312/wjo.v11.i12.534
 

Herb, C. C., & Hertel, J. (2014). Current concepts on the pathophysiology and management of recurrent ankle sprains and chronic ankle instability. Current Physical Medicine and Rehabilitation Reports, 2(1), 25-34. DOI: 10.1007/s40141-013-0041-y
 

Kulie, T., Slattengren, A., Redmer, J., Counts, H., Eglash, A., & Schrager, S. (2023). Obesity and Women's Health: An Evidence-Based Review. Journal of the American Board of Family Medicine, 36(1), 34-45.