Mark: Hi, it’s Mark from TLR. I’m here with Dana Ranahan of Body Works Sports Physiotherapy in North Vancouver, BC. And we’re going to talk about ankle injuries. How are you doing Dana?
Dana: Hi Mark. I’m good.
Mark: So ankle injuries they hurt. I know I’ve had really bad ones. My ankles are really loose and floppy. What’s going on there?
Dana: Well, it’s a really common thing. And I think that’s one of the things I wanted to raise this issue is that people do have ankle injuries, kind of think, oh, I just sprained my ankle. It’s no big deal, but you can end up then having recurrent ankle sprains. And sometimes then people do get kind of loose in the ligaments around the ankle because they get sprained and strained and overstretched so many times.
So if you have an ankle injury, it’s really important, even though it seems like a minor sprain and you just want to tape it up and go back to it, it’s really important to figure out what you did, how bad it was and what you can do to get stronger and improve your balance. So you don’t keep spraining it again.
Mark: So what kind of symptoms do people have? They’ve twisted their ankle, quote, unquote, it hurts there’s swelling. What’s the typical, how do you diagnose that and go about treating it?
Dana: Well, it kind of depends on how it happens. Though, sometimes I work a lot with soccer, so we see it on a soccer field and you can see someone go over or they either step on someone’s foot or they trip over someone. Similar things happen to people who step on a rock or something, or, you know, trip on a curb. And so they would feel like the sudden giving way. Sometimes people actually fall down sometimes not, but they will have like a sudden pain, swelling in the ankle. Sometimes it swells up pretty quickly and not always, but often if it smells really fast, it can be an indicator of a bigger injury to the ligamentous system.
So the biggest thing you need to do is get it compressed and get it elevated and iced to try to keep the swelling under control. So it doesn’t blow up too big because that will just make your pain worse. So those are the kind of the first things. And then I think it is important to have it checked. Maybe you need an x-ray, if you might have a minor fracture or sometimes you pull a piece of bone off, if the ligaments been sprained, so you could check in with a physio.
We can certainly take a look at it and send you back for an x-ray if need be. And regardless we can help you understand what you’ve done. In the acute phase, it’s really important to get some advice on how to manage it. So you manage it properly and then we can look at what needs to happen going forward.
Mark: So when you’re actually treating it, do you have to wait until the swelling has subsided?
Dana: No, I think it’s almost better to see it relatively sooner than later. I mean, often you can’t do as much exercise or functional work, like to get stronger when it’s that swollen. But we can do a lot of work to try to bring swelling down with ultrasound or some techniques with our hands to bring swelling down. Tape it. Give them exercises to do, to try to control swelling, et cetera. And that advice and a simple treatment in the beginning, it was really helpful to get them on the road to recovery quicker.
Mark: What’s the typical treatment time?
Dana: I think it depends on the severity of sprain of the ligament and sprains can be kind of mild to severe, let’s say. So a milder sprain would probably be more like a four to six week period, medium sprains, maybe six to eight weeks. And if it’s more severe, it could be eight to 12 weeks.
So three months sounds like a long time, but sometimes it takes time for all the ligaments to heal. And everything’s, I get stronger, especially if you’ve done a more significant sprain. So, you know, depending on severity, it can range over those time frames.
Mark: So when you making the ligaments stronger with exercises and stretching, I guess I’m not sure what the process is, but does that actually tighten the ankle or keep it tighter? So you don’t have floppy ankles later on?
Dana: Well, if you have a more severe sprain, some of the fibres of the ligament can actually be torn more. So the more severe sprain, sometimes it doesn’t bounce back and bring you all the way back. If you have a milder sprain, maybe a partially torn it, like twenty-five percent of the fibres are torn or something, you can actually have that knit back and tidy up and tighten up and snug up again.
So that’s why if you’ve had a milder sprain, it’s more important to figure out what to do to get it tighter and stronger so that if you re-sprain it again, you’re not just making it worse and worse and more torn and more torn. Because if that happens, then you end up with looser ankles and it’s harder to stabilize.
We can do muscle strengthening and balance exercises. But if the structural integrity of the ankle, meaning the ligament that support the joint are you know, kind of attenuated or broken down, then they can only do so much. And it may mean that you’re going to be a recurrent ankle sprain person. And as you get older, we’re looking at arthritic change in your joints.
Mark: How important is it to get in, to see a physio, soon after the ankle injury?
Dana: It’s very important. I would suggest that people try to get in to see us within like three to five days or three to seven days after their injury to get things going as quickly as possible.
Mark: If you’ve hurt your ankle in North Vancouver, doing anything, the guys to see are Body Works Physiotherapy. You can book online at body-works.ca or you can call them and book at (604) 983-6616. Get your ankles looked after. Thanks Dana.
Dana: Thanks Mark. Take care.