Ask A Physio: When Can I Go Back To Sport After An Ankle Sprain?

Ankle injuries are one of the most common acute injuries we see, especially amongst athletes. Pretty much everybody who has played a sport has sprained an ankle before, leading to a lot of people minimizing the injury and not taking it seriously.

There is often pressure from coaches (and ourselves!) to make a quick return to sport because “it’s just an ankle sprain.” Just because ankle sprains are common does not make them insignificant. We know that only about half of people who experience an ankle sprain seek help. We also know that up to ONE THIRD of individuals experience chronic ankle instability after an ankle sprain.

It is in your best interest to handle ankle sprains correctly. Otherwise, they come back to bite you again and again.

Below is a list of factors that physiotherapists consider while gradually returning you to your activity of choice. It’s not just about going back to practice and taking it easy for a day or two then going to play a game next week. In the clinic we test and re-test all of these aspects and gradually help people progress up to their top level of functioning.

If you want to manage your sprain yourself you absolutely can, especially it’s not your first time and you know what to expect. But please know that going back too soon is a really good way to get re-injured and everything that is listed below is relevant no matter who is doing your rehab.

(Looking for what to do immediately after an ankle sprain? Read our Top Ten Tips for Acutely Sprained Ankles in our blog!)

Factors to Consider in Ankle Sprain Rehab:

Pain:

• Do you have any pain?

• Does it hurt while exercising or afterwards?

• How intense is the pain and where is the location?

• How long after the pain starts will it subside and return to baseline?

Swelling:

• Is there swelling?

• Is it old or new swelling?

• How does the swelling fluctuate with activity?

Physical Aspects:  

• Does your ankle move in all directions as well as the other foot?

• Is the strength equal in all directions?

• How is the endurance?

• What about the power?

• How about your sensorimotor control - do you have complete proprioception back (a fancy word for knowing where your body is in space)?

• Is your balance as good on that side?

• How about your dynamic control - can you maintain stability and balance while moving and doing other things?

• Do you need a brace? Which kind of brace? When should you wear the brace? Can you wean off of the brace?

Mindset:

• How do you feel about your ankle?

• Are you confident that it will be fine?

• Do you feel that your ankle is stable?

• Are you psychologically ready to go back?

• In contact sports, does the thought of someone checking you from behind make you nervous?

Functional and sport performance:

• Can you hop? Jump? Change directions?

• Can you jog? Run? Sprint? Run a gentle curve? Cut to the side? Slam to a stop?

• What about things specific to your sport? For example if you are a soccer player can you pass? Receive a pass? Shoot? Tackle?

• Are you fast enough to react to another player?

• Can you do all the drills in practice? What about a scrimmage?

We want you to be able to do all of these things and do them well before you fully return to your sport. It’s a long list to consider and not always easy to answer every question, but it’s important to run through this list and make sure you are really ready to return to sport.

If you suffer with ankle sprains, get it checked out by a physiotherapist - we are the experts at this! We are always happy to see you and will do our best to get you back out there as soon and as safely as possible.

Need to book an appointment? Book online, send us an email or call us at (778) 630-8800. Happy healing!

Devon's Top Ten Tips for Sprained Ankles

I have a looooong history of sprained ankles. My first sprain was at the age of 10 or 11 - we were hiking down from Garibaldi Lake and I couldn’t keep my ankle from twisting to the inside. By the time we got to the car my ankle was the size of a grapefruit.

Since then I have sprained my ankles countless times. When I was in my 20’s, I was playing ultimate four nights per week and rolling one or both of my ankles at least once per game. I ate Advil like candy, relied heavily on ankle braces and taping and pretended it wasn’t happening. I kept brushing it off until I couldn’t.

It was then I sought the help of a physiotherapist. I had never seen one before and I had no idea what to expect. After my first visit, I was given simple things to help prevent a sprain - Stretching! Basic balance exercises! A warm-up! - and started on the process of actually healing. My physio also looked at things that were contributing to my constant sprains, like posture and muscle weakness in my core and hips.

I started to feel better. No longer was I treating Advil as an appetizer to sport - I was able to play without any pain. It was also a period in my life where I wasn’t sure what career I wanted and the idea of being a physiotherapist interested me. Fast forward 15 years and it’s the best decision I have made.

Two days ago, I gave myself a double ankle sprain - see exhibit A on the right. Impressive, hey? I am currently hobbling around with little grace or dignity. I thought this may be a good time to remind myself of best practice in ankle sprain rehab. So, I present…

Devon’s Top Ten Tips for Sprained Ankles

1. This may sound silly, but avoid them at all costs! For me, that means wearing proper footwear. I managed to do this one by jumping off a 2 foot platform IN BARE FEET. Given I have no ankle ligaments on the outsides of my ankles, I should have known better.

2. There is currently a lot of controversy surrounding the use of ice after an injury. Here’s my approach: I use ice for 48-72 hours after a sprain, for 10-15 minutes at a time. After that, I use heat or ice depending on how I feel.

3. Protect your ankle! That may mean using a brace or reminding your three year old not to jump on your foot. This one is important - trust me.

4. Compression is key immediately after an ankle sprain. This helps control the swelling. A tensor bandage is a great option as are compression socks (of which I have several pairs after my pregnancies) and make sure your compression is not too tight. You want to control the swelling, not cut off blood supply to your foot!

5. Elevate your foot - it helps the swelling go down. It’s also a great excuse to sit and watch the last few episodes of Game of Thrones before tonight’s season premiere…

6. While you’re at it, early controlled motion is crucial to healing. I move my ankles constantly within their pain-free range, up and down as well as side to side. There are several benefits - the muscles pump the swelling out, the synovial (aka good) fluid in the joint moves around to nourish and lubricate the joint, and the pain signals to your brain decrease. And this is just a few of the benefits!

7. REST. When your foot is telling you to sit down, SIT DOWN. I know this one is obvious, but it’s hard to avoid those things we need to do. I am guilty of this one - the dishes need to get done, the laundry pile is obscene - but the better you are at taking care of yourself, the faster you will get back to normal life.

8. Walk normally as much as possible with whatever speed you can muster. If this is impossible and you need a gait aid (ie. cane or crutch), so be it. The last thing you need is for your back to go out on you.

9. When you’re feeling better and that ankle is looking like an ankle again, remember to go slowly. The scar tissue laid down is weakest at 3 weeks post-injury, prime time for re-injure your ankle. Be smart about your activities.

10. Seek the advice of a physiotherapist. We are trained in the ways of short term and long term rehabilitation for these buggers. We look at things that contributed to your ankle sprain. How’s your core? What about your glutes? What’s your sense of balance like? There are several factors that can make you more likely to sprain your ankle and most of them are correctable.