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The Irish Society of Chartered Physiotherapists

When is an ankle sprain NOT just an ankle sprain? by Alan Harrington

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Ankle injuries are so common. They can happen to anyone, from athletes to the average person going about their daily life. One of, if not the most frequently encountered ankle injury is a sprain. As simple as missing a step on the stairs, walking down the cobbled streets of Galway to getting caught in a slide tackle in a match. Often quite sore straight away. Hard to keep weight on it. That sharp, stabbing pain with each step, but more often than not you’re able to keep going on about your day.

Even with ankle sprains, we have a grading system for how damaged the ligaments in your ankles are damaged. Don’t get caught up on Googling how bad your sprain is, because “Dr. Google” can’t see your foot and ask you detailed questions like a Physio can. Here is a few tips on distinguishing if you have sprained your ankle;

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  • Pain and swelling in the area. Often our baby toe gets caught under our foot and has our entire body weight come down on top of it. You’ll likely experience pain and swelling around the area of the bony part of the ankle. Swelling may not always be present or easy to spot.
  • If you’re limping, that’s your body telling you It isn’t happy putting weight on the foot.

However, depending on the severity of pain, point of impact mechanism of injury you may have a fracture pretending to be a sprain. Sprains are damage to the ligaments in the ankle while fractures are damage to the bones that make up the foot and ankle. As therapists, we don’t have X-ray vision to see into your ankle; however we do have a set of tests that you must pass in order to clear our mind of any serious injury at play. If we aren’t satisfied, we may refer you for further imaging such as an X-ray or MRI.  Signs and symptoms are quite similar and only really differ in severity and duration of pain.

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  • A visible deformity at the site of pain is a strong indication of a fracture present.
  • Severe pain. The complete inability to stand after the injury. A limp you feel has lasted for a bit too long. Usually coupled with sharp, shooting pain up the lower extremity.
  • Often a site of injury may bruise. Bruising does not immediately indicate a fracture. Ugly, colourful bruises help highlight the area of damage.

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If you suspect you have an ankle sprain we advise you to use the RICE protocol after the injury. REST, ICE (to site of injury), COMPRESS and ELEVATE (when possible). Doing this can reduce swelling and pain immediately after the injury and can aid in distinguishing between the two types of injuries. If you suspect your injury may be severe you should seek medical attention.

If you are ever unsure, here in the clinic we have a team of Physios, Physical, and Athletic therapists competent in diagnosing your injury and educating you on the next steps in recovery.

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