Chartered Physiotherapists are trained to assess an acute (recent) ankle sprain and using a specific set of assessment criteria known as the Ottawa Ankle Rules we can determine if a fracture is likely to have occurred. If we suspect a fracture we can refer you for an X Ray or MRI scan (In Ireland, depending on your health insurance policy, you may need your doctor to sign off on the request). The results of the scan will help us decide how best the ankle should be managed and depending on the extent of the damage, an orthopaedic specialist may need to be consulted in addition to receiving physiotherapy.
Most ankle sprains result in soft tissue injury, usually to the ligament structures which support the ankle joint. The lateral (outer) ligaments are more commonly injured which may result in pain, swelling, restriction of movement and a loss of function e.g. walking properly, or ability to run and take part in sports. If this type of injury is not treated correctly, on-going weakness and instability may result, making further injury much more likely down the road. Simply taking anti-inflammatories is not sufficient.
On occasion, depending on the nature and force of the injury, bony damage, possibly in the form of a fracture may occur.
However I must stress that ankle fractures are very rare and delaying a physiotherapy assessment until an X ray has been done to rule out a fracture can potentially delay the start of your rehabilitation by several weeks. This may result in slower healing, delayed recovery and more time spent on treatment. You may also develop further injury by continuing to use the injured ankle in ways it is not fit for.
The best time to see a Chartered Physiotherapist is within 2-3 days of the injury. You can self-manage the ankle within this period using the PRICE regimen, following which the acute swelling and inflammation should have started to subside to allow us to start your road to recovery.
We have new evidence to support the use of Physiotherapy (manual therapy and exercise) for ankle sprains which confirms that those who get treatment recover more quickly.
If treatment is started early, most ankle sprains will recover and allow a return to full activity in a few weeks (or less) depending of the grade of injury.