Ankle Sprain Treatments

Jacky Chiang — Wed, 10 Apr 2019 01:22:52 +0000

Treatment for Acute Ankle Sprains

Acute ankle sprains are one of the most common sporting injuries treated by physiotherapists. Fortunately, most are simple to treat and can be managed a series of exercises and stretches taught by your physiotherapist.

What is an ankle sprain?

Ankle sprains cause stretching of ligaments around the ankle which can result in minor to complete tears. The most common sprain occurs when the ankle rolls outward with the foot turned inward. Causes for ankle sprains may be from twisting of the foot on uneven surfaces, falls or trauma from sports activities.

What are the symptoms?

Ankle sprains and ligament tears may cause:

Pain
Swelling
Bruising
Tenderness to touch
Ankle instability

What are the grades for ankle sprains?

Grade I: Minor tear or stretching of the ligament(s) with mild pain and swelling around the ankle. There should be minimal or no pain with weight-bearing activities (e.g. walking).

Grade 2: Partial tear of the ligament(s) with moderate pain, bruising and swelling. Walking is painful and ankle may feel unstable.

Grade 3: Complete tear of the ligament(s) with severe swelling, bruising and tenderness around the ankle. It is usually too painful to walk and the ankle feels unstable. Severe tears may be associated with fractures or high ankle sprains.

What is the treatment for ankle sprains?

Ankle sprains usually heal without surgical intervention. For severe tears, immobilisation with moonboot and crutches is recommended for initial management. Further investigations such as X-ray, ultrasound or MRI may be required for moderate to severe tears.

General initial treatment for ankle sprains in the first 48-72 hours is the RICE protocol (rest, ice, compression and elevation).

R – Rest from any activity that aggravates the pain to promote tissue healing.

I – Wrap a towel around ice pack, a bag of crushed ice cubes or frozen peas. Ice the affected area for 15-20 minutes every two hours. There should be no extreme pain.

C – Apply firm pressure with bandage or brace. Ensure that there is no discolouration or increase in swelling which indicates restricted blood flow.

E – Elevate the affected foot above the level of your heart.

Initial goal is to reduce pain, swelling and restore full range-of-motion. Your physiotherapist may tape your ankle to protect it from twisting or rolling. Next phase of rehabilitation will focus on improving strength, flexibility, balance and then gradual return to activities.

How long does it take to heal?

Grade I	Approx. 2-3 weeks
Grade II	Approx. 6 weeks
Grade III	Approx. 6-12 weeks.

According to a systematic review, ligament healing and mechanical stability of ankle occurs from 6 weeks to 3 months after injury, particularly Grade III ankle sprains. However, you may still experience mechanical laxity or subjective ankle instability up to one year depending on the severity of injury.

Need Help With An Ankle Sprain?

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More information

Foot and Ankle Injuries

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The Best Treatment For Low Back Pain

Jacky Chiang — Fri, 29 Mar 2019 06:42:42 +0000

What is the best treatment for lower back pain?

There is no one-size-fits-all treatment of low back pain. There is strong evidence that physiotherapy is recommended as the first line of defense against lower back pain, resulting in reduced use of pain medications and less overall health-care expenses. Generally, the first step to relieving back pain is to understand pain. Studies have shown that pain is poorly related to tissue damage and sometimes, the pain that persists is more about sensitivity rather than the damage. Our nervous system is like an alarm system which warns us of danger. However, in approximately one in four people, the alarm does not calm down after ramping up and stays extra sensitive, decreasing the tolerance to normal, safe movements. The spine is resilient and the tissues around it are adaptable.

It is recommended to avoid prolonged sitting, standing or repetitive twisting and stay active within pain-free range for initial management. Exercises, spinal mobilisations, acupuncture or heat pack are some effective non-pharmacologic management of lower back pain. Compelling evidence has shown combined manual therapy, exercise and education are efficacious for low back pain. For further information, please see your physiotherapist for an individually tailored program.

How do you strengthen your lower back and core?

Depending on individual presentations, strengthening of the lower back may involve functional exercises such as deadlift and squats. However, lower back pain conditions usually require retraining normal movements with manual therapy, exercises or stretches first. Exercises favouring a particular direction of movement can decrease pain, disability and medication use. Depending on the patient preferences or presenting symptoms, some people may also benefit from motor control exercises as it has similar effects in treating chronic lower back pain compared to graded activities. For further guidance, consult with one of our physiotherapists.