Ankle injuries are common. Acute ankle injury occurs after a sudden sideways or twisting movement of the foot. It can occur during athletic events or simply during everyday activities. If the force to the ankle is excessive it can result in a break. It can be difficult to distinguish between a bad ankle sprain and a broken ankle and for this reason an X-ray is normally arranged.
How your ankle injury is managed will depend on the type and severity of the injury and it’s important to remember that each injury is individual. The ankle may be immobilized for a period of time in a splint, cast, Air cast boot or strapping. Some ankle fractures require surgery.
REHABILITATION
At some point you will be advised to start moving the ankle. It is vital that the ankle is kept moving (to the point of discomfort) even though it is sore to move. Not moving the ankle can lead to other problems such as continuous swelling, stiffness, reduced movement, poor balance reactions and weak muscles. By doing a few simple exercise you can increase the speed of recovery and significantly reduce the risk of further injury.
If your ankle has been immobilized, e.g. in plaster, it will feel very strange when you first put your foot to the floor- this is normal and should resolve within a day or so.
You can assist the recovery of this by massaging the sole of your foot or by rolling a small ball under the foot to stimulate the sensation in the soft tissues.
Don’t be afraid to move!
You may be referred to physiotherapy once the specialist is happy for you to start moving the joint.
ICE
Ice can be used in the first 24 to 48 hours after injury to cool the affected tissues and also in the later stages of healing as a means of pain relief and swelling management.
Chipped/crushed ice in a damp towel appears to be the most effective application of cold. Ice should be applied for 20 to 30 minutes every two hours. Always check the condition of the skin because it is possible to get an ice burn.
CONTRAST BATHS
Contrasts baths are used after the initial phase of injury to reduce swelling. The ankle is immersed in bowl of warm water for up to four minutes followed by a cold bath with ice and water for one to two minutes. This should be repeated three to seven times. A cold bath should be used to finish
ELEVATION
The affected ankle should be elevated above the level of the heart. When elevated the limb remember to remove any tub grip. Do not ice the ankle at the same as elevating.
MASSAGE
If you have had an operation, massage the scar once it is well healed using moisturizing cream. This will help to reduce hypersensitivity and improve scar mobility.
WALKING
When advised by your doctor or physiotherapist, try to walk normally with even strides (heal to toe). If you are provided with crutches, try to put as much weight through the bad leg as pain allows and continue to walk as normally as possible.
Even by doing all the right things to help yourself, your body will take time to recover. By following the advice given by your physiotherapist the pain will become less, the swelling will reduce and if you carry out the following exercises as instructed the muscles will become stronger, the movement will become greater and your balance reactions improve.
Please do the following exercises as instructed by your physiotherapist:
- Lying on your back or sitting. Bend and straighten your ankles briskly. If you keep your knees straight during the exercise you will stretch your calf muscles.
- Sitting or lying: Rotate your ankle. Change directions
- Sitting with your foot on the floor: Alternatively raise the inner border of your foot (big toe) and then the outer border (little toe).
- Sit with one leg straight out in front of you. Put a band around your foot. Gently pull the band and feel the stretch in your calf
- Sit in chair with your feet touching the floor. Push toes down to raise heel
- Assume position with foot closet o chair, keep the whole foot flat on the floor, move that knee forward and backward so that you feel a stretch
- Position your body against a wall, point toes directly toward wall and hold heel down, lean into wall so that you feel a stretch.
- Stand, push up on your toes.
- Stand, lift one leg.
Ref: BTUH and SUTH UK