Sprained Ankle Treatment
There are 3 phases of treatment for sprained ankles. The 3 phases of sprained ankle treatment are designed to address the primary challenges that the body faces as it shifts through the physical gears of repair.
Reading through the relevant material there is much talk of what we need to do for sprained ankle treatment, but the body does all the actual cellular healing. So let’s look at what the body gets up to while we are RICEing ourselves and booking acupuncture sessions?
Phase 1 – Acute Sprained Ankle Treatment
Reduce Swelling – Prevent Further Damage
This phase of sprained ankle treatment is the one that most people have a fairly good grasp of. The RICE principle makes it nice and easy to remember Rest, Ice, Compression, Elevation.
When your sprain your ankle badly enough to need treatment the brain immediately registers that the tissue is damaged, this triggers the nervous system into action and the first thing it does is send lots more blood to the area. Blood not only contains the molecules and cells needed for the repair job, it is able to act as a ‘field dressing’, immobilising and cushions the sprained ankle protecting it from further damage. An additional ‘treatment assist’’ that the nervous system and blood collaborate on immediately after a sprained ankle comes in the form of pain.
Pain is the single best treatment for a sprained ankle. Without pain neither you nor your outdoor living, hunter gathering ancestors would give a sprained ankle any respect whatsoever, let alone seek treatment for it. Pain is an essential part of the bodies dashboard display, it prevents us from continuing to run on sprained ankles which protects them from further damage.
Phase 2 – Sub – Acute Sprained Ankle Treatment
Boost Circulation – Encourage Healthy Scar Formation – Re-establish Joint & Muscle Mobility
After the initial immobilising, blood engorged, immediate repair and pain phase of the bodies sprained ankle treatment protocol the second phase of sprained ankle repair kicks in.
This second phase of sprained ankle treatment is often completely overlooked. The hallmark of this phase is having someone (usually a professional) get stuck into some hands on treatment. In my practice Phase 2 sprained ankle treatments include acupuncture, manual mobilisation, deep tissue release, hot & cold, vibration massage, guasha (scraping scar tissue ) & joint manipulation.
From the bodies perspective the second phase of sprained ankle treatment is about the re-activation of movement, further blood flow, collagen repair and scar tissue formation. From the outside looking in there is a reduction in pain, a reduction in swelling and an increase in mobility. The reduction in pain seen in the second phase of sprained ankle treatment & healing is the bodies way of encouraging you back into movement.
Movement reactivates the supporting muscle tissue which will be needed to prevent further injury down the track, movement also helps to mobilise scar tissue as it forms, preventing it from being too inflexible. Movement of a sprained ankle in the second phase of treatment also increases blood circulation, the constant supply of fresh blood assists with ongoing repair of the collagen fibres in the ankle.
As the cartilage repairs and healthy scar tissue forms, full structural stability of the ankle joint returns. The truth according researchers is that the repair of cartilage in the ankle may continue for weeks and months longer than we have traditionally thought. If this is the case it calls us to continue to be respectful of our ankle long after the obvious sprained ankle symptom phases.
Phase 3 – Rehabilitation Of Sprained Ankle – Beyond ‘Treatment’
Restore Full Joint Movement – Strengthen Muscle – Re-Establish Proprioception
This phase of healing and treatment for sprained ankles is commonly understood but seldom followed through on particularly well. Even when Phase 1 & 2 of appropriate sprained ankle treatment have been observed, almost all patients will end up with a trio of joint stiffness, loss of muscle strength & poor proprioception (balance) following a decent sprained ankle event.
In many ways the only thing we can do for ourselves regarding cartilage repair in the ‘rehabilitation’ phase of sprained ankle treatment is be a bit careful. This necessary caution is most particularly in relation to sports activities that involve sudden changes of direction and other similarly chaotic movement based activities. The only thing we can do about scar tissue in this phase of sprained ankle treatment is keep the ankle moving nicely (this assumes there are no ‘unticked boxes’ left over from phase 2 of treatment).
The primary focus of the 3rd sprained ankle treatment phase is far more about the nervous system and its connections to muscle tissue that supports the ankle, than it is about the ankle tissue itself. As big of a deal to your body as digestion but far less commonly spoken of is ‘proprioception’. Proprioception is essentially the never ending conversation that the back of you brain (your cerebellum) has with the body about movement and body position. Proprioception is not only the basic information that enables the brain to move the body it is how the brain registers the threat of trips, falls, twists and injuries so that the muscles can act to prevent them.
Research shows that people with stubborn pain and injury issues in the ankle and lower limb have proprioceptive issues. It may be that ‘faulty proprioception’ in the longer term, following bad sprained ankles is the primary reason behind the subsequent ankle sprains that so many suffer from and the need for many subsequent treatment processes.
The need to establish full proprioceptive control at the ankle following a bad sprain needing treatment means movement. Controlled activity and lots of it, combined with carefully prescribed balance and coordination exercises are the treatment for choice. The inconvenient truth is that these activities need to be observed for many months in some cases, and even years for those who had pre-existing weakness in the ankle prior to injury and treatment. The more convenient truth is that like looking after our teeth, 5 minutes at a time is enough in the longer term to restore proprioceptive strength to the ankle.
Sprained ankle treatment is a far bigger and far more important topic than many of us realise. There is a whopping pile of scientific and circumstantial evidence to suggest that often ‘she won’t be right’ if we leave sprained ankle repair and sprained ankle treatment to chance.
The sheer number of ankles that ‘re-injur’ speaks for itself. I believe that one day research will clearly show that if we leave poor proprioceptive control, muscle weakness and poorly formed scar tissue in the ankle we open the door to degenerative tissue changes like osteoarthritis in the longer term.