Have a Sprained Ankle? How We Can Help Many of us have had a sprained ankle at some point in our lives. Whether a small roll of the ankle or a big swollen blow out, the anterior talofibular ligament is actually the most common ligament sprain in our bodies – and can also be one of the most painful. You don’t have to be an athlete to suffer a sprained ankle either. Although sprained ankles are commonly caused as a result of a sports injury, repetitive overuse, poor posture, or a wild night out in NYC in 5 inch high heels. They can also be caused by an old untreated ankle injury that has caused an imbalance of oppositional muscles, muscular compensations, and impact to a joint or ligament near the foot. In older people, accidents and weakness or instability can lead to ankle sprains; and can take longer to heal as a result of weaker muscular systems. How Do I Know if I Have a Sprained Ankle? Our team at Urban Wellness Clinic can assess and let you know. However, there are some common symptoms you can look out for if you have rolled your ankle and are experiencing increased pain. Pain is the first indicator that something could be wrong, but pair this with swelling, bruising, throbbing on the outside of your ankle, and the inability to bear weight more than four steps are also good indicators. A sprained ankle is painful, often times so much so that they will force you to stay off of your feet due to limping. If the ankle is discolored, purple, green from bruising, this is a severe ankle sprain and an x-ray should be ordered. Personal side note, a severe ankle sprain while playing soccer in high school was one of the reasons I was inspired to enter join the chiropractic profession. This one injury lead to some nasty symptoms down the road, including chronic headaches and shoulder instability. What Should I Do If I Roll My Ankle If you feel like you’ve done some damage (and it’s not broken), make sure you are elevating your foot. The primary course of action should always be RICE – Rest, Ice, Compression, Elevate. RICE treatment is often recommended for 7-10 days and includes ensure you get your ankle moving within 24-48 hours. If you feel like there has been some more severe damage damage done, ensure you have met with your doctor to have the necessary tests completed to see if it is in fact broken or that there is a possible tear in the tendons on the outside of your ankle. Different Grades of Sprains Sprains can manifest themselves in different grades depending on the severity of the injury. These grades are labelled as grade 1, 2, and 3 in order of severity: Grade 1: A first degree ankle sprain is when the ligaments have been stretched but are not torn. The symptoms include: Mild pain Some swelling Some joint instability Mild joint stiffness Difficulty jogging or jumping Recovery ranges from 4-6 weeks Grade 2: A second degree ankle sprain is the most common of all ankle injuries. It includes the partial tearing of a ligament. Symptoms include: Significant swelling Moderate pain Bruising Some loss of motion or use of the ankle Difficulty walking Recovery ranges from 3-6 months Grade 3: A second degree ankle sprain is the most severe, and is characterized by a completely torn ligament with symptoms that include: Severe swelling Severe pain Instability of the joint Extreme loss of motion Painful walking Recovery is expected to be several months long What About Inflammation? Inflammation sets in to jump start the healing process but in a chronic ankle sprain can set in when there isn’t enough lymph drainage. Inflammation results in swelling, which is at its peak in the mornings and after there has been an increase in movement. Battling the inflammation begins with RICE, but it’s important to include movement exercises, lymph drainage, and proper rehab exercises to heal properly. Available and Suggested Treatment ABC’s are a series of movements used to decrease inflammation and increase the spatial awareness of the ankle called proprioception by outlining the alphabet with your foot. Start with small movements withe lower case letters and work up to larger movements of upper case letters once the stiffness diminishes. After 3-5 days of the ABC’s, the addition of the use of the theraband, exercise tubing to stretch and strengthen, inversion and eversion by pulling the toes towards the head are all excellent ways to begin and maintain treatment. Normatec compression boots offer varying degrees of compression to aid in the healing process by pushing out the inflammation gradually. This is a newer, but very effective therapy used in our office. RockTape helps drain stagnant inflammation that will get stuck in the ankle where we stand and walk around due to gravity pushing the inflammation downward. We use Rocktape in the office to help “pull” the inflammation out of the ankle and up towards the heart so it can processed by the lymphatic system and help accelerate healing. Keeping your Anatomy In Motion (AIM) by using Gary Ward‘s rehabilitation technique to retrain your gait so you teach the brain to recognize normal walking patterns. This is an important part of the recovery process as it prevents permanent changes in your gait caused by overcompensation. Maintaining a healthy gait pattern is what will prevent chronic pain in the future, along with weakened ligaments and the risk of further or additional injuries. All of our practitioners at Urban Wellness Clinic are trained in AIM to help out patients recover from ankle sprains. Muscle Memory Of An Ankle Sprain An inversion ankle sprain, meaning you roll to the outside of your ankle, shifts the entire body towards that side of the injury. So if you sprained your left ankle, your brain will perceive your center to be over to the left. Remember, an ankle sprain doesn’t just affect the foot and ankle but works its way up the kinetic chain. There is a great photo of the lateral fascial line from Thomas Meyer’s Anatomy Trains that shows how an ankle sprain can affect other parts of the body. If you overstretch the ligaments and tendons down on the outside of the ankle, somewhere else in the body will compensate. That overcompensation for the now weak ankle could be anywhere along that fascial line including up by the neck. We’ve seen many patient over the last 12 years with headaches, neck pain, and shoulder instability due to an old sprained ankle. How do we figure out these compensations? We like to test and not guess using NeuroKinetic Therapy or NKT. This is a muscle testing technique to locate compensations in the body. It helps guide what rehab exercises we give, where to strengthen and what to stretch in the body with precision and specificity. Don’t Wait Until It’s Too Late When a sprained ankle goes unaddressed, there can be chronic long term effects. These can include inhibited or “sleepy” glutes and hamstrings – which can cause pain when walking in an uphill fashion, or walking up stairs. This particular pain can work its way up to the neck and the upper back resulting in pain and headaches. An uneven gait can result from an unhealed ankle sprain when you’ve overcompensated to avoid pain. An uneven gait leads to muscular asymmetries and discomfort, and can have a snowball effect that leads to bigger, longer term musculoskeletal issues. Natural Remedies Amongst these natural remedies, there are supplements and foods that assist in regenerating your joints, and reduce inflammation. Bromelain is an enzyme found in pineapple skin, and supplements containing this powerful enzyme helps with healing as it has an anti-inflammatory effect. Collagen helps ligaments and tendons heal, both of which are made of collagen protein. We love Bubs Naturals Collagen, which is high quality collagen powder, pesticide-free, kosher certified non-GMO, gluten-free, and Keto Friendly. Dark cherry juice is rich in antioxidants and is known to help reduce inflammation. Omega 3 fats, found in fish oils are necessary for wound healing and will reduce inflammation caused by an injury. Green superfood powders that contain nutrient rich rich sea vegetables and minerals will support the rebuilding of the ligaments and tissues. MSM has an anti-inflammatory effect, and is a source of sulfur which is necessary for tendon health. It’s Best to Get it Looked At! A sprained ankle can be very problematic if left unattended. If you have an ankle injury and are concerned that it may be a sprain, it is imperative you have it assessed by a healthcare professional that can see movement asymmetries and retrain movement. The sooner treatment begins, the better the chance of a complete recovery. At Urban Wellness Clinic, we help our patients determine the most effective course of treatment, and you will be given thorough instructions on what your next steps will be. This will include stretches, supplements, suggested diet alterations, exercises, timelines, and supplies/equipment required to correct the injury completely. Prompt attention can ensure you don’t suffer from further injuries and chronic pain. Feel free to ask us any questions at hello@urbanwellnessclinic.com or schedule a 15 minute call with one of our providers 212-355-0445. In good health, Dr Emily Kiberd Share this post