5 Reasons You Should Always Seek Treatment for a Sprained Ankle

Ankle sprains are extremely common among physically active populations, accounting for up to half of all sports injuries in the USA, and researchers estimate that fewer than half of ankle sprains sufferers seek medical attention for their injury. Of ankle injuries that do receive medical attention, as many as 40% are thought to be misdiagnosed or ineffectively treated, resulting in chronic ankle pain and instability.

Considering these facts, it is not only important to seek professional treatment for your ankle injury, but it is crucial to get an accurate diagnosis and personalized rehabilitation, to restore ankle function and reduce your risk of future injury.

Types and Grades of Ankle Sprains

Ankle sprains involve stretching or tearing of ligaments – tough bands of connective tissue that support and stabilize the ankle bones. Ankle sprains range from mild to severe, depending on the number of ligaments involved and whether the ligament is merely stretched, partially torn, or completely torn.

Ankle sprains are different from ankle strains, which affect the soft tissues, or fractures that affect the bony structures. An ankle sprain can result in ankle instability due to ligament laxity that increases an athlete’s risk of injury – in fact, a previous sprain is the predominant risk factor for predicting a recurrent injury.

There are three basic categories of ankle sprains:

1. Lateral inversion sprains are the most common type, accounting for around 80% of all ankle sprains. Inversion sprains affect the ligaments of the outer ankle, and about 75% result in long-term instability and increased risk of recurrent sprains. Lateral sprains can affect any or all of 5 lateral ankle ligaments.

2. Medial eversion sprains affect the deltoid ligament on the inside of the ankle. They occur when the foot rolls inward toward the big toe, forcing the inner ankle beyond its normal range of motion, and stretching or tearing the ligament. Eversion sprains are relatively rare, accounting for only 5% of all ankle sprains.

3. High ankle sprains occur in the lower leg, just above the ankle, affecting the ligaments that connect the tibia and fibula bones of the lower leg. High ankle sprains are less common than lateral ankle sprains, but they are generally more severe, more painful, and may take much longer to heal.

The severity of ankle sprains is graded on a scale of 1-3:

• Grade 1 – a mild sprain involving stretched ligaments
• Grade 2 – a moderate sprain involving a partial tear
• Grade 3 – a severe sprain with a complete ligament tear

Is it Really a Sprain, or Something Else?

According to research, as many as 40% of ankle injuries are misdiagnosed or incorrectly treated. Other conditions that share similar symptoms are often mistaken for ankle sprains, especially when the diagnosis is symptoms-based. For example, high ankle sprains are often misdiagnosed as lateral sprains. Even imaging technologies like Xray or MRI can fail to adequately visualize the structures of the ankle, especially when inflammation is present.

Conditions that mimic ankle sprains include:

• Lateral talar process fracture
• Stress fracture
• Peroneal tendon subluxation
• Fracture of the medial malleolus
• Talar dome fracture
• Calcaneus anterior process fracture
• Achilles tendon rupture
• Gout
• Posterior tibial tendinosis
• Superficial peroneal nerve compression
• Peroneal tendon tears
• Fracture of the fifth metatarsal

Misdiagnosis can lead to ineffective treatment that prolongs the patient’s pain and suffering while neglecting to adequately address damaged tissues. High-resolution diagnostic ultrasound imaging can help to accurately identify injured structures, and differentiate ankle sprains from other conditions.

The Importance of Ankle Rehabilitation

Most physically active people are accustomed to various aches and pains from training and overuse, and many may ignore an ankle injury if it can still bear a load, even if it hurts. Over time, an untreated ankle sprain may stop hurting as inflammation goes down and tissues heal. But damaged tissues do not always heal effectively, and you may have scar tissue, ligament laxity, reduced range of motion, and reduced ankle stability, all of which can alter your gait, create compensation patterns, and increase your risk of recurrent injuries.

Here are 5 important reasons to seek holistic sprained ankle treatment and rehabilitation, even after you think your ankle has healed:

1. Increased ankle instability
   One of the greatest risks after a joint injury is future development of osteoarthritis. Symptoms of joint osteoarthritis include pain, stiffness, crackling and popping, and reduced range of motion. While joints like the hip and knee can be replaced when osteoarthritis becomes severe, the outcomes of ankle replacement surgery are often far less optimistic. An ankle replacement can leave you with an unnatural walking gait and multiple disabilities that dramatically reduce your quality of life. Early treatment and rehabilitation can reduce your osteoarthritis risk and improve your ankle function, now and in the future.
2. Risk of osteoarthritis
   Ligaments are tough connective tissues, but they have limited blood flow and low elasticity. As the ankle rolls and bears weight in an unnatural position, ligaments can easily be stretched and torn. Some sprains cause micro tears that are hardly noticeable, while others can be severe, dramatically impacting your ankle’s ability to support and stabilize your body weight. Walking on a sprained ankle is never a good idea, regardless of the severity. An unstable ankle increases your risk of injury while walking, running or playing sports.
3. Compensation patterns
   After an ankle sprain, especially a very painful one, it’s natural to shift your weight to the uninjured leg as you stand and walk. But over time, compensation patterns can become habitual, and they affect more than just your ankle. Shifting your body weight also shifts your center of gravity in the direction of the supporting leg, and this in turn alters your posture and disrupts your joint alignment along the entire kinetic chain. Over time, your gait and stance are permanently affected, and joints and muscles throughout your body are overloaded, setting you up for pain and reducing your physical performance.

4. Sensory-motor deficits
   Efficient gait relies on symmetrical loading and coordinated muscle recruitment patterns on both sides of your body. An ankle sprain can cause your gait mechanics to quickly erode, unevenly distributing forces across your joints. An ankle sprain – even an old one – can set you up for future ankle, knee, hip and back pain. Gait deficiencies affect your upper body as well, causing postural, neck and shoulder issues.
5. Gait deficiencies
   Even a minor ankle sprain can cause irreparable damage to your sensory-motor system by altering proprioceptor messaging to the brain. Deficits in sensory-motor signaling can cause alterations in biomechanics, gait, proprioception, balance, postural stability and mobility. Research shows that even a minor ankle sprain can damage the cartilage of your ankle joint, setting off a cascade of joint degradation. Ankle rehabilitation that includes sensory-motor retraining is critical for restoring symmetrical gait mechanics and optimizing ankle function.

Rehabilitating Ankle Instability

Ankle instability can affect your entire body due to reduced control of force loads. Structures that are not designed to manage loads may become strained, and compensation patterns may arise to help mediate forces during physical activity. Without rehabilitation, your ankle sprain can contribute to knee, hip, and back pain, and an untreated ankle injury can reduce your balance and increase your risk of falls as you age.

After an ankle sprain multiple factors can be affected by ankle instability, including:

• Postural control
• Joint kinematics
• Muscle coordination patterns
• Foot and ankle strength
• Balance
• Proprioception
• Force distribution
• Joint range of motion
• Joint integrity

One of the most common sensory deficits after an ankle sprain is the inability to estimate how much weight-bearing load your ankle can support. Sensory-motor function can be restored using a reweighing platform that provides perturbation, activating muscle receptors to help reprogram your brain-body connection for optimal motor control.

During sprained ankle rehabilitation, it is important to strengthen the ankle and its supporting structures, and to incorporate stretching exercises to regain full joint range of motion. But before loading the ankle, you may need to repair soft tissues that have healed poorly via treatments like shockwave therapy and orthobiologic injection therapy. Fascial densifications and adhesions may need to be addressed, to recover functional range of motion and restore muscle activation patterns.

Get Advanced Sprained Ankle Treatment and Rehabilitation in NYC

Neglecting to rehabilitate your sprained ankle can lead to pain syndromes, poor balance and reduced mobility later in life. If you want to remain physically active and avoid future injuries, sprained ankle rehab is a must.

At NYDNRehab, we used advanced technologies to accurately diagnose and treat your ankle injury. Your healing journey begins with a comprehensive diagnostic exam using high-resolution ultrasonography. Dynamic ultrasound imaging lets us visualize your foot and ankle in real time, for quick and accurate diagnosis.

Our research-grade ultrasound equipment gives us capabilities for superior microvascular imaging (SMI) to detect early signs of blood flow to damaged tissues, and sonoelastography to test tissue density and elasticity.

Our human movement lab pairs state-of-the-art technology with proprietary software to give us quantitative information about various movement parameters, such as joint kinematics, load distribution, muscle coordination patterns and more. Our ultrasound-guided regenerative therapies and orthobiologic procedures help to restore tissue integrity, to optimize ankle function.

You don’t have to settle for low-tech, one-size-fits-all treatment protocols offered by conventional physical therapy clinics. Our personalized one-on-one approach to patient care means you will get customized treatment supported by advanced technologies and tailored to your specific needs. If you’re ready to rehab your sprained ankle and get moving again, contact NYDNRehab today.

If you're ready to rehab your sprained ankle
contact NYDNRehab today

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