Physical Therapy is Crucial After Ankle Sprains, I'll Explain...

Have you landed on your foot awkwardly while jumping playing basketball? Rolled your ankle while playing tennis or pickleball? Stepped into a pothole while running? These are just a few of the many ways an ankle sprain may occur.

I'm Dr. Matt Feder, a Doctor of Physical Therapy at Charge Physical Therapy and Performance in Miami Beach. In this post, I'll cover what actually happens when you sprain an ankle - and why proper physical therapy afterward is crucial for a full recovery.

Ankle sprains are caused by an excessive stretching force to the ligaments that provide stability to the foot and ankle joint. This occurs when the joint is moved past its physiological end-range of motion. These injuries are typically abrupt in nature and can happen in the blink of an eye. Ankle sprains are highly prevalent within the population, so don't feel bad if it's happened to you. What's most important is taking the proper steps following the injury.

First and foremost, we will assess what ligaments of the ankle are involved. If you rolled your ankle outward and have pain on the outside, it is likely you suffered a lateral ankle sprain. An inward sprain with pain on the inside would be a medial ankle sprain. In addition, a more severe type of injury known as a high ankle sprain is caused by a combination of inward and upward motion of the foot typically coming down forcefully from a jump or in contact sports. It's important to also know that ligament sprains are also graded on a scale from I, II, and III from least to most severe.

• A grade I would be an over-stretching of the involved ligaments and may or may not have coinciding pain, swelling, and bruising.
• A grade II may have partial tearing of the involved ligaments, increased pain, swelling, and bruising.
• A grade III would be moderate to full tearing of the ligaments and more severe swelling, pain, and bruising.
• In all three types, you may have difficulty bearing weight through that side initially.
• The good news is these injuries will heal with conservative management in physical therapy.

More severe injuries may require immobilization in a boot however research has showed that this may not be necessary. Many studies have advocated for functional treatment instead of immobilization as it provides a more rapid recovery of ankle mobility, early return to work and physical activity without compromising stability of the ankle. Very rarely is surgery needed for an ankle sprain. However, if surgery is indicated your return to full function may take additional time and require longer treatment supervised under a Doctor of Physical Therapy. It is important for us to know all the aforementioned details of the injury as the rehabilitation process may look different for each. We don't recommend WebMD, YouTube, or Google exercises as the details of the nature of your injury aren't understood by those platforms.

Did you know that Physical Therapists are direct access providers in the state of Florida?

This means that you can see a physical therapist for an initial evaluation and follow up sessions without a referral. Seeking physical therapy first immediately following an ankle sprain will speed up your healing process, it will also decrease the likelihood of recurrence and decrease ankle-related medical costs incurred.

What will we do in physical therapy?

First, I will ask you what your goals are. This includes recreational hobbies, work, caring for your kids, etc... My ultimate goal is to get you back to doing what you love. If I don't do that, it would mean I didn't succeed at my job. I take that aspect of my job very seriously and will do everything in my power to make sure you return do what you enjoy doing as fast as possible. With that said, rehabilitation will initially focus on decreasing pain and swelling progressing to foundational strength, balance, and stability. Once appropriate, we will work on more functional training that will re-integrate your body into moving how it would pre-injury.

The late stages of rehabilitation will mimic aspects of the sport, hobby, or recreational activity you would like to return to. A comprehensive return-to-activity program supervised by a physical therapist can help prepare your ankle for those demands. Delaying rehabilitation after an ankle sprain may increase the risk of another sprain. Progressive ankle strengthening is a key part of preventing recurrence.

Why is physical therapy crucial to my recovery?

One of the biggest complaints I hear from patients is a feeling of lack of confidence in the ankle following a sprain. In my experience, this is always correlated to a lack of proper rehabilitation following the injury. An injury of this nature requires graded exposure to selective tissue stress to send signals to the body to heal. If this doesn't occur, compensational patterns may occur which will result in a loss of function. If this sounds familiar, the good news is that it's not too late. Confidence can still be restored in physical therapy.

I will list out some of the many benefits of physical therapy for ankle sprains below for your appreciation:

• Pain relief
• Earlier resolution of swelling and weight bearing
• Improves stability
• Improves strength
• Improves confidence
• Avoid surgery
• Avoid pain-killing medication
• Decrease long-term cost associated with ankle related injuries
• Prevent recurrent sprains
• Ensures a smooth return to function and sport

At Charge Physical Therapy and Performance, we take recovery seriously. You can think of your Doctor of Physical Therapy as a mentor, but for injury rehabilitation. We will guide, motivate, and support you through your recovery journey.

If you have recently suffered a foot or ankle injury, set up an evaluation with us as soon as possible to begin your return to full function.

Any questions? You may contact me at drmatt@chargephysio.com – I would love to help!