Sprained ankles can happen for all sorts of reasons – walking or running on uneven ground, tripping off a kerb or landing awkwardly. Whatever the cause, the injury occurs when you roll, twist or turn your ankle, usually outwards, beyond its normal range of movement.
This can stretch or tear the soft tissues that hold your ankle bones together. These soft tissues include ligaments, which are tough bands of supportive tissue, fascia and muscles. Symptoms of a sprained ankle can vary depending on the severity of the sprain, but generally they include pain (especially when weight bearing), swelling, bruising, restricted range of movement, and a feeling of instability in the ankle.
The initial symptoms mean that you usually can’t put any weight on your ankle and need to rest as you recover. Following the RICE protocol is sensible to help bring down swelling and support the injury:
Most ankle sprains will start to feel better after about 2 weeks, although a more severe sprain can take longer and its generally a good idea to avoid strenuous exercise for about 8 weeks.
However, once you have recovered from the initial sprain it is tempting to forget about it and not to continue with longer term rehabilitation and maintenance. This can leave your ankle weakened and can lead to longer term issues such as chronic ankle pain, instability and even osteo-arthritis.
From a myofascial perspective part of the problem is that any damage to your ankle will inevitably damage the fascia in the area. Fascia can change from its normal fluid state to more solidified tissue similar to micro-scarring in the tissues. Any restrictions in your fascia change the balance in your body as you unconsciously move differently to accommodate these restrictions.
Initially these changes in balance are very obvious as you put all your weight on your good leg while your ankle sprain repairs. Moving your weight onto one leg also shifts the function of the muscles in both legs and changes the balance in your pelvis. Over time you may not fully change back to an equal balance on both legs and this can create further changes and restrictions in the fascia of both legs and your pelvis.
The knock on effect of such changes in body balance may not be realised for months or years, although you may start to notice that you re-injure your ankle or that leg. You may also develop pains in other areas of your body that you may not even associate with the original ankle sprain. However as your fascia forms a bodywide web of connected tissue and restrictions can therefore spread to other parts of your body through tensional changes in this web. For example, a common pain pattern from an ankle sprain on, say your left side, can be shoulder pain that develops on your right side.
Ways to prevent longer term problems developing after an ankle sprain are to focus on a combination of rehabilitation exercises to improve your balance and proprioception – for example, standing on one leg, ankle rotations and toes scrunches – and myofascial exercises to release fascial restrictions that will have formed.
Myofascial exercises include stretches and working with a myofascial ball. They are slow and progressive exercises, each lasting for at least a couple of minutes to allow time for the fascia to start to release and let go. You can find out more about myofascial exercises to help after an ankle sprain in our self-help video: