Do ankle sprains need physical therapy?
Updated: May 16
Short answer/TLDR: yes, ankle sprains need physical therapy.
What is an ankle sprain?
An ankle sprain is a fairly common injury that occurs when the ligaments that support the ankle are stretched or torn. The ankle joint is made up of bones, muscles, tendons, and ligaments that work together to provide stability and mobility. When the ankle is twisted or turned beyond its normal range of motion, the ligaments can become damaged, leading to a sprain. The most common area for this to happen is on the outside of the ankle. Though much more rare, it can also happen on the inside of the ankle. Ankle sprains can range from mild to severe, depending on the extent of the ligament damage.
Symptoms of an ankle sprain may include:
Pain or tenderness around the ankle
Swelling or bruising
Difficulty walking or bearing weight on the affected ankle
Stiffness or limited range of motion
Instability or feeling like the ankle may give way
Do I need to RICE my ankle sprain or is there something better?
While RICE (Rest, Ice, Compression, Elevation) has been widely used for many years, POLICE is a more recent approach. POLICE emphasizes early movement and optimal loading of the injured area to promote healing, prevent stiffness and weakness, and improve overall function. It is typically used for the first few days to weeks after an injury occurs. The main steps of POLICE are to protect the injured area from further damage, gradually introduce movement and activity to the area, apply ice to reduce pain and swelling, compress the area with a bandage to reduce swelling, and elevate the injured area above heart level to reduce swelling and promote blood flow.
One quick note about using ice: Ice is still recommended for an acute ankle sprain as it can help reduce pain, swelling, and inflammation. Applying ice to the affected ankle within the first 48-72 hours of injury can help limit the extent of the damage and promote healing. However, there is some debate about the optimal duration and frequency of ice application as some recent studies suggest that prolonged or excessive use of ice may interfere with the natural inflammatory process and delay healing.
Therefore, while ice can be helpful in managing the symptoms of an ankle sprain, it is important to follow your healthcare provider's instructions and not overdo it. Applying ice for 15-20 minutes at a time, several times a day, is generally safe and effective for most people. If you have concerns about the use of ice for your ankle sprain, it is best to speak with your healthcare provider.
What is POLICE and why should I use it for my ankle sprain?
The acronym POLICE stands for Protection, Optimal Loading, Ice, Compression, and Elevation. This is a newer approach to managing acute soft tissue injuries such as sprains, strains, and bruises. So what does it stand for?
Protection: Protect the injured area from further damage by avoiding activities that may aggravate the injury or using crutches, splints, or braces if needed.
Optimal Loading: Gradually introduce movement and activity to the injured area to promote healing and prevent stiffness, weakness, or other complications. This may involve gentle range of motion exercises, stretching, and strengthening exercises as appropriate.
Ice: Apply ice to the injured area for 15-20 minutes at a time, several times a day, to help reduce pain, swelling, and inflammation.
Compression: Wrap the injured area with an elastic bandage to help support the joint and reduce swelling.
Elevation: Elevate the injured area above heart level as much as possible to help reduce swelling and improve blood flow.
The POLICE approach is a simple and effective way to manage acute soft tissue injuries in the early stages of healing. However, it is important to remember that every injury is different and may require individualized treatment based on the severity and location of the injury, as well as the individual's overall health and fitness level.
So do ankle sprains need physical therapy?
Ankle sprains will absolutely benefit from physical therapy to help reduce pain, swelling, and stiffness, and restore function and mobility to the affected joint. Physical therapy may also help reduce the risk of reinjury and improve overall athletic performance.
Physical therapy for ankle sprains may include a variety of interventions, such as manual therapy (hands on treatments), dry needling, range of motion exercises, strengthening exercises, balance training, and gait training. Your physical therapist will work with you to develop a personalized treatment plan that addresses your specific needs and goals.
Physical therapy can be an effective and safe way to manage ankle sprains, improve function and mobility, and prevent future injuries.
How can physical therapy help prevent future ankle sprains?
Physical therapy can play an important role in preventing future ankle sprains by addressing underlying muscle weakness, joint instability, and balance deficits that may increase the risk of reinjury.
Here are some ways that physical therapy can help prevent future ankle sprains:
1. Strengthening exercises: Physical therapy may include exercises to strengthen the muscles around the ankle joint, including the calf, shin, and foot muscles as well as muscles further up the leg and around the hip as they also play an important role in overall strength and stability of the entire lower extremity. Strengthening these muscles can help improve joint stability and reduce the risk of reinjury.
2. Range of motion exercises: Physical therapy may include exercises to improve ankle joint mobility and range of motion. Improving ankle joint mobility can help reduce stress on the joint and improve overall function.
3. Balance training: Physical therapy may include exercises to improve balance and proprioception (awareness of body position and movement in space). Improving balance can help reduce the risk of falls and future, recurrent ankle sprains.
4. Taping or bracing: Physical therapy may involve the use of ankle taping or bracing to provide additional support and stability to the joint during activity. This can help reduce the risk of reinjury and improve overall function.
5. Education and training: Physical therapy may include education and training on proper footwear, techniques for safe movement and activity, returning to activity and sport, and strategies for injury prevention.
Overall, physical therapy can be an effective way to prevent future ankle sprains by addressing underlying risk factors and improving joint stability, mobility, and function. Untreated or improperly treated sprains can lead to long-term complications such as chronic pain, instability, or arthritis.
You said proprioception... what is that?
Proprioception is the sense of body position and movement in space. It is an important component of balance and coordination and plays a critical role in preventing ankle sprains.
When you walk, run, or jump, your body relies on proprioceptive feedback from the muscles, tendons, and joints to maintain balance and stability. This feedback helps your body adjust to changes in terrain and movement and make quick, coordinated movements to avoid injury.
After an ankle sprain, proprioceptive feedback can be compromised, leading to decreased balance and increased risk of reinjury. Physical therapy can help restore proprioceptive feedback by including balance training and exercises that challenge the ankle joint in various positions and movements.
In PT, exercises are designed to challenge proprioception by performing movements on unstable surfaces such as foam pads, wobble boards, or balance disks. As the exercises become easier, the challenge can be increased by performing the exercises with eyes closed, or by incorporating movements such as twisting, reaching, or throwing a ball.
By improving proprioception, you can help reduce the risk of future ankle sprains and improve overall function and performance.
When should I start physical therapy after an ankle sprain?
The sooner, the better! PT is a great place to start after an ankle sprain and while it may seem crazy to go see someone when it's painful, swollen and bruised, the sooner you do it, the quicker you can start to heal.
While fractures can occasionally accompany a sprain, it's not as common as might think. Physical therapists have screening tools to determine if you might need an x-ray before beginning PT on your ankle sprain and can refer you on if needed. Most of the time, this isn't the case and we can begin treatment right away to reduce swelling and pain, restore normal range of motion, and aid in healing. The best part? You don't need a referral or prescription to begin PT so you can get started right away!
If you have a history of ankle sprains, have had a recent ankle sprain or are concerned about your risk of future ankle injury, the PT's at Nashville Physical Therapy & Performance are here to help you navigate your recovery, injury prevention, and returning to the things you love.