If you’re anything like me when I was young, you may have let your ankle ‘recover’ by itself after rolling your ankle. Oh, how I was wrong… Fortunately, you’ve taken the first steps to understand and rehabilitate your ankle sprain. Well done!
Firstly, what is an ankle sprain?
An ankle sprain is typically an injury to one or more of the ligaments on the medial or more commonly, lateral aspect of the ankle. The ligament is a fibrous structure connecting bone to bone, designed to keep your ankle joint stable. However, with the ankle being a very mobile joint in nature, when overstretched in a particular position, you can ‘roll’ the ankle and sprain the ligaments in your ankle. The job of the ligament is to prevent this excessive, unwanted movement. Unfortunately, it doesn’t always do its job properly and that’s when an injury can occur.
Recovery from an ankle sprain is crucial in order to achieve your return-to-sport goals and gain long-lasting results. Lateral ankle sprains commonly occur during sporting activities such as netball, basketball, AFL and football.
40% of first time lateral ankle sprains may develop chronic ankle instability within 1 year (Doherty et al, 2016).
This is the reason why when you sprain your ankle the first time, it can often lead to further ankle sprains in the future if not managed properly. Weakness, stiffness, lack of proprioception, or the inability to generate power and be agile, are issues that need to be addressed to be able to return back to 100% function. This is important in not only your desired sport or activity but as well as reducing future injury risk.
Performance Testing
Performance testing is applied when you are close to returning to your desired sport and the physiotherapist runs through functional tests. These determine a safe return to sport without exposing you to further risk of re-injury (Clanton et al, 2012).
Our main 4 functional tests are:
1. Ankle Range of Motion Test
The dorsiflexion lunge test is a weight-bearing test performed by placing the foot perpendicular to a wall and lunging the knee toward the wall without allowing the back heel to lift off the ground or any tightness/aches in the front of the ankle. You will continue going further and further away from the wall until a maximum distance away from the wall is achieved. This distance is measured and determines your score. An ideal score is > 10cm.
2. Single Leg Balance Test
Balance is a vital component in sport and the reduced risk of injury. The Y-balance tests your balance in several movement directions, testing you in the anterior, posteromedial, and posterolateral directions. The posteromedial component is the most representative of overall performance components. The aim is to achieve a similar distance in both legs, reducing asymmetries.
3. Agility T-Test
Agility is the ability to change direction rapidly. Agility involves three main components of physical capability, cognitive process and technical skill.
The agility T-test measures your ability to move in all different directions: forwards, side to side and backwards. The T-test is a short course spanning 10m forward and 5m side to side. A good time for you to aim for is between 8.9 to 13.5 seconds.
4. Vertical Jump Test
If you display muscular strength imbalances then you may be exposed to an increased risk of ankle injuries. The vertical jump test evaluates your strength, speed, energy, and dexterity and estimates power jumps. The affected leg is compared to the “good” leg and should mimic similar results before being allowed to return back to sports.
Conclusion
The decision to return to sports following an ankle injury is based upon a multitude of factors. The decision to return to play should be a joint decision between you and your treating physiotherapist provided you pass the objective measures and functional performance tests. The tests are designed to evaluate your balance, strength, range of motion, agility and vertical power, as a whole a safe return and performance.
IF YOU NEED HELP GETTING BACK TO WHAT YOU LOVE, YOU SHOULD BOOK IN FOR AN ASSESSMENT WITH A PHYSIOTHERAPIST HERE
If you need any assistance with your rehabilitation journey please feel free to contact the clinic at (02) 8018 9599 or email me at nathanael.chan@fxnlrehab.com.au.
Your Local Physio,
Nathanael Chan
@nate.physio | @fxnlrehab
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