Written by Hui Le Ngoo, Physiotherapist at In Stride Health Clinic
As a lifelong sports-lover, I have always been obsessed with being active, even long before I became a physio. As such, it wasn’t uncommon for there to be periods where I’ve had to take time off certain activities to let the body recover. In all fairness, I have been pretty lucky - no broken bones, no Achilles rupture, no torn ACL’s. However, there has been a major injury that I have sustained, and that is the ankle sprain.
You might be thinking, it was just an ankle sprain, how is that… major? Just walk it off!
Back in high school, I played a lot of soccer and basketball. One time when I was 17 years old, a few mates and I were just mucking around on the basketball court during lunchtime. I had scored a few tough shots, and I was feeling confident so I thought I’d go for a drive towards the basket. I went forward and felt myself not stepping on the ground but the defender’s foot, and next came the feeling of my foot twisting sideways to almost 90 degrees. I collapsed in intense pain, unable to put any weight on that leg. Unfortunately, the intensity of the pain did not subside over the next few hours, and I still could not put weight on that foot that evening.
My family (myself included) hadn’t a clue on what to do for my ankle - we all thought that all I needed was to “walk it off”; with enough rest, the ankle should heal by itself. But no, that was not enough. The pain did not get better the next day, not to mention the swelling. Dad eventually took me to the hospital and I was given crutches.
What is a lateral (inversion) ankle sprain?
One of the most common lower body injuries is the ankle sprain, with the most common types being the lateral ankle sprain (inversion), medial ankle sprain (eversion), and high ankle sprain (syndesmosis). The former is the most common, where the foot is forcefully rolled inwards, and the ligament(s) is/are unable to withstand the high forces and is/are consequently injured. This usually happens in sports or running, where higher forces are involved, however it is entirely possible and not uncommon that simply walking on uneven surfaces could lead to an ankle sprain.
Ankle sprains are ranked from Grade 1 (slight stretching of ligament[s]), Grade 2 (partial tearing of ligament[s]) to Grade 3 (complete tear of ligament[s]). Generally, the more severe the injury (the higher the grade), the longer and more complicated the recovery journey.
Importance of ankle rehabilitation and physiotherapy for ankle sprains.
Thinking back, although I never had any imaging done, it was quite a severe sprain and would have been at least a Grade 2 sprain. Not knowing the importance of properly rehabilitating injuries meant that I was left on crutches, in severe pain and disability, and was out of sports for more than 4 months. With a good rehabilitation program, I could have potentially halved the time to return to sports.
With what I know now, I would have done everything differently. It is imperative to control pain and swelling in the early phase of rehabilitation, and the acronym PEACE can be very helpful. They stand for Protect, Elevate, Avoid anti-inflammatories, Compress, and Educate. After the first few days, the acronym LOVE comes into play, which stands for Load, Optimism, Vascularisation, and Exercise. But how do we know when to avoid anti-inflammatories such as Nurofen, and when do the benefits of using ice to help with pain and swelling outweigh the risks? When is it safe to load our ankle, and what exercises do we do? How do we determine if the injury is so severe that we may need to use a brace? But chronically using a brace can lead to chronic stiffness is managed properly?
Although an inversion ankle sprain is most common, other more severe injuries should not be ruled out. These include avulsion fractures, chronic ankle instability, or even an underlying disease that led to the ankle sprain event in the first place. It is important to seek a professional healthcare practitioner early on to correctly diagnose the condition, and properly manage it with the appropriate treatment modalities and exercises. This can significantly reduce the time it takes for you to return to normal activities and minimise any ongoing/lingering symptoms.
Hui Le completed his Doctor of Physiotherapy at the University of Melbourne. He previously has obtained a Bachelor of Science, majoring in Human Structure and Function.
With a keen passion for musculoskeletal and sports physiotherapy, Hui Le is a strong believer in a combination approach of hands-on manual therapy, education, evidence-based management, and a large focus on client-tailored exercise prescription. In addition to working at the clinic, Hui Le has been and continues to be involved with local footy teams.
In his downtime, Hui Le enjoys doing all things active including weight training, playing basketball and exploring the outdoors. Hui Le loves travelling and is fascinated by different cultures - he wishes to finally visit Europe in the next few years. As a Malaysian-born Chinese, he also speaks fluent Mandarin Chinese.
Hui Le offers hands on physiotherapy, clinical Pilates, hydrotherapy and exercise based rehabilitation at In Stride Health Clinic. He is available most weekdays including out of hours appointmens and Saturday mornings.