Ankle Pain

Ankle sprain

What is ankle sprain?

Ankle sprains happen when the ligaments of the ankle are suddenly stretched, or in some instances partially torn, usually on the outside of ankle.

What causes the ankle sprain?

  • Sports injuries: twisting or rolling over of the ankle underneath the leg
  • Simple injuries: e.g. stepping over the edge of a step or a kerb causing the ankle to collapse inwards or outwards
  • Severe ankle sprains in the past can cause recurrent sprains

What are the signs and symptoms?

  • Sharp pain with immediate swelling
  • Pain over the outside of the ankle
  • Occasional a tingling sensation in the foot if there is nerve irritation

How do I manage this problem?

  • PRICE: initial treatment requires the following
  • Protection: Soft elastic ankle supports may help to rest your joint during the acute phase and gives you the confidence to move
  • Rest: depending on the severity of the problem try to limit prolonged periods of standing and walking for a few days.
  • Ice: An ice pack or a frozen bag of peas wrapped in a damp tea towel for a maximum of 15-20 mins, 3-4 times a day helps ease the swelling.
  • Compression: Using a soft compression or crepe bandage helps to control inflammation. This should cover from your toes to your knee.
  • Elevation: Elevate the ankle with the support of a cushion in lying so your foot is above your chest to help effective drainage.
  • Activity modification: Limit your activities that stress your ankle, especially sporting activities. This gives the ligaments time to recover from the injury whcih may take 4-6 weeks.
  • Anti-inflammatory medications: Simple anti-inflammatory tablets such ibuprofen may help with the swelling and pain.
  • Exercises: The attached PDF document shows you exercises to improve mobility, strength, control and function. It is important to do these exercises regularly
  • Prevention: It is important to strengthen your ankle to avoid recurrence. Control (or proprioception) exercises are important to prevent recurrence.

When to seek medical attention?

  • If you have sharp bone tenderness in the lower leg or the prominent bony parts of your ankle.
  • If you are unable to bear weight through the leg or walk four steps

What are other treatments available?

If your symptoms last over 3 months despite trying other treatment methods

  • Pain medications: Your GP may consider giving you stronger pain killers or anti-inflammatory for you to return to you normal activity
  • Physiotherapy: Your physiotherapist may be able to provide a detailed assessment and treatments such as joint mobilisations, specific functional exercises or acupuncture to improve your symptoms.
  • X-ray: If there is a suspicion of a fracture your GP may arrange this at an early stage.
  • Specialist opinion: Symptoms lasting over 6 months despite GP and Physiotherapist treatment may need a specialist opinion
  • Steroid injections: May help if your symptoms fail to improve over 6 months
  • MRI: Is rarely necessary unless your specialist GP or Physiotherapist feel that you have significant instability of your ankle
  • Surgery: Is rarely needed

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