Interesting thought about ankle sprains

An article came out in USA Today Vulnerability to ankle sprains varies with age.   I wanted to add a few interesting thoughts from a Physical Therapists perspective.

1. This is something I have noticed with ankle sprain injuries for many years and in some ways seems kind of strange.  Why is there more sprained ankles in basketball (40%) compared to soccer (8%)?  Granted I don't know in this study if it is matched to the percent of those actually playing the sport, which could skew the percentage if a higher number of people possilbly play basketball compared to soccer.  But think about this:  basketball is always on a flat surface and players often times wear hightop shoes and brace or tape their ankles, compared to soccer which is usually on a grass natrual field, with tiny not very supported shoes and they are always moving around a round ball on the ground.  From the outside one would think that soccer would probably see more sprains.  Or, because soccer players actually train in a more challenging situation that they are better prepared to reduce the risk for ankle sprains.
2. I thought another interesting statement in the article needs to be looked at deeper as well:
• "The good news is that most ankle sprains feel better in a few days and heal completely in a few weeks. But previous studies suggest 60% of people who have one sprain will have another or will suffer long-term instability, weakness or pain."
• My question is do they heal completely?, if 60% will suffer long term difficulties.  I would like to think that this is not healing completely.  If we take simple knowledge of tissue damage, we need to see that complete healing probably takes longer than a few of weeks.  This is true probably for most injuries.  I am afraid we don't allow the body go through all the stages of healing and work to fully rehabilitate from an injury like an ankle sprain usually.  There is loss of strength, flexibility and proprioception after an ankle sprain.  Unless we work to retrain all of these appropriately we are most likely looking at further problems.  Also we need to look to see if there was a movement impairment that may have been the cause behind the injury.
• An example I can give is a patient I had once that I saw the day after her ankle sprain and talked to her about acute treatment (RICE - rest, ice, compression and elevation).  Then importance of working to normalize her walking as soon as possible.  She came back about a week later and said she was fine and did not think she needed any more therapy.  I asked her to try and stand and balance on that one foot.  To her amazement (not mine) she couldn't!  I explained what all happens after an ankle sprain and that just because the swelling and pain was down, did not mean that it was completely healed.  So after a couple more visits over about 4 to 6 weeks and instruction on proper exercise progression to regain strength, flexibility and proprioception her ankle was fine.

My advice if you suffer an ankle sprain, do not think it is fine just because the swelling and pain are less in a few weeks.  See a physical therapist to get proper treatment to make sure that you do fully rehabilitate from an ankle sprain and reduce the risk of reinjury.  If you do play sports you are at higher risk for ankle sprains, so as part of your training do specific functional exercises to reduce your risk of injury.  Talk to a physical therapist to learn functional training exercises that you can do for your specific sport.

picture by: By Suzy Parker, USA TODAY