Expert Interview - Physio on Ankle Sprains
Premiership Physiotherapist Neal Reynolds talks to Sportsinjuryclinic.net about ankle rehab and returning to full fitness.
Neal works more on the muscles on the inside - eccentric inversion, rather than working on the peroneals - the evertors on the outside. To him they are no-where near as important as the eccentric strength of the inversion muscles, to control the over-inversion movement. To do this he will use resistance bands. Balance exercises are also important.
From then on it is all about gradually increasing load. If the ankle swells up this means you are doing too much and need to slow down a bit. After 4 weeks if the ankle is still swelling up then it is likely that something else has happened, such as damage to the surfaces of the ankle joint.
There are other more complicated injuries such as high ankle sprains and syndesmosis injuries which are only now becoming more recognised. Ankle sprains can be very complicated, but in most cases they can be treated effectively.
Most people can go without a ligament at the outer ankle. In many footballers who have sprained their ankle, an MRI scan would show up that there is no ligament there and it doesn't cause a major problem as long as they have the balance around the ankle.
The last stages of rehab for an ankle sprain are very different to a muscle injury. For example when going out to do the last few sessions before returning to sport, Neal looks at what will really test the ligament. Running isn't usually a problem in straight lines. So what he does is spend time working from a larger turning circle to a smaller circle and twisting and turning movements. They may be some pain on kicking a ball, more so if the ankle was injured on the inside, rather than the outside.
