The ankle sprain is one of the most frequent injuries, among amateur and professional athletes alike, but also as a result of a simple, everyday awkward movement. According to the High Authority for Health (HAS)In France, more than 6,000 ankle sprains occur every day. Faced with this injury Often underestimated, a few key actions are essential from the very first minutes to limit damage and avoid complications such aschronic ankle instabilityWhat to do right after a sprain How to recognize its severity, and how to properly ankle rehabilitation To prevent recurrences? Here are our concrete recommendations and mistakes to avoid.
| Key points to remember in case of an ankle sprain: Immediately : apply the method RICE (Rest, Ice, Compression, Elevation) in the first 48 hours. Ne pas Do not apply heat, massage, or put pressure on the ankle.Visit If the pain persists after 48 hours, in case ofhematoma diffuse or inability to put the foot down.Rehabilitation should not be neglected: It is what prevents recurrence (up to 70% in athletes). |
What is an ankle sprain?
A ankle sprain corresponds to a stretching or tearing of the ligaments ankle injury, most often caused by a sudden twisting motion: an inversion of the foot (the foot turns inwards).external sprain is defined by this forced inversion and affects one or more bundles of the lateral collateral ligament (lateral collateral ligament). It represents nearly 90% of ankle sprainsMore rarely, the sprain involves the medial collateral ligament or the tibiofibular ligaments, on different mechanisms (eversion, external rotation of the foot).
How to recognize an ankle sprain: warning signs
Before taking action, we must identify the symptoms not to underestimate the injuryThe main signs to watch for:
- a sharp and immediate painconcentrated on the outer side of the ankle, accentuated when bearing weight;
- rapid swelling (edema) in the minutes that follow, linked to local inflammation;
- difficulty walking or to put the foot down in moderate to severe sprains;
the appearance of a hematoma after a few hours: a bruise indicating internal bleeding, common in sprains of moderate to severe severity.
The different levels of severity: the 3 grades
- Grade 1: Stretching of a bundle of the lateral collateral ligament, without rupture or avulsion. Moderate pain and swelling, ankle remains mobile.
- Grade 2: One bundle is torn, the others are stretched or partially ruptured. Sharp pain, swollen ankle, possible bruising.
- Grade 3: Total tearing of several bundles, often with an audible cracking sound. Severe pain, ankle completely unstable and impossible to move.
When should a serious sprain be suspected?
If you have a deformation visible from the ankle, creak audible at the time of the trauma or total inability to move the ankleyou need to consult a doctor without waiting. One radiography will rule out a fracture associated.
The “RICE” rule: immediate actions in case of a sprain
In case of ankle sprainthe rule RICE (Rest, Ice, Compression, Elevation) is the method reference of first aidApplied quickly, it limits theinflammation, reduces the pain and promotes recuperation.
- R = Rest: Immobilize the ankle and stop all activity. Continuing to walk risks aggravating the injury. ligament injury. The HAS recommends avoiding any pressure during the first few hours (crutches if necessary).
- I = Ice (Glace): apply cold 15 to 20 minutes every 2 to 3 hours for the first 48 hours, always with a fabric between the ice and the skin. The cryotherapy reduce the blood flow local, theedema and the hematoma.
- C = Compression: un elastic bandage firm (but not painful), from the base of the toes towards the calf, to limit theedemaMonitor circulation (tingling, bluish toes) and remove it before sleeping.
- E = Elevation: raise the ankle above the level of the the heart, several times a day, to promote the drainage of edemaParticularly effective when combined with ice.
Common mistakes to avoid in case of an ankle sprain
- Do not consult a healthcare professional. A poorly treated sprain can develop into a motor inhibition, an rehabilitation blockage, a chronic ankle instability or recurrences. Consult if the pain persists after 48 hours, in case of significant edema, diffuse hematoma, inability to put weight on the foot, or if a deformity/creaking sound has been observed.
- Apply heat for the first 48 hours. Heat dilates blood vessels and worsens swelling and hematoma. Ice is preferable.
- Massaging or manipulating the ankle too early. Massaging the injured area in the first few hours may worsen the injury. Wait for a professional assessment.
- Continue walking or putting strain on the ankle. Lack of rest compromises healing. Immobilization and no weight-bearing are necessary for the first 24 to 48 hours.
- Neglecting rehabilitation. Once the pain subsides, the ankle remains fragile and prone to recurrence without re-education adapted (mobility, strengthening of stabilizers, proprioception).
Causes and risk factors: why relapse is a real possibility
The sprain is most often accidental in origin, but certain factors increase the risk (and especially the risk of recidivism:
- the patient's age, sex and experience;
- some history of ankle sprains ;
- un proprioceptive deficit of the ankle;
- a deficit of muscles which mobilize the ankle;
- a difficulty in performing the ankle flexion ;
- a weakness of the muscles of the hip ;
- shoes unsuitable for sports activities.
The first risk, even for a mild grade 1 sprain, remains the recidivism In athletes, the rate can reach 70%with a key element being chronic instability and early-onset osteoarthritis. That's the whole point of rehabilitation.
Why rehabilitation is essential after a sprain
After one sprain, the re-education is essential for regaining mobility, strength and stability, and above all for limiting the risk of recidivism. The physiotherapist works on 6 complementary areas:
- joint mobility : gentle and manual mobilizations to recover the degrees lost before weight-bearing work;
- muscle strengthening : various exercises following an ankle sprain can be carried out gradually;
- proprioception : re-education of balance and control, key to avoiding relapses;
- the treatment of edema : manual drainage, cryotherapy and pain relief techniques;
- pain management : often linked to stiffness, hence the priority given to mobility (TENS if needed);
the walking pattern : correct the limp and apprehension with support, for example in front of a mirror.
Allyane therapy in the rehabilitation of ankle sprains
La Allyane therapy is a method of neuromotor reprogramming based on themotor imagery, the proprioception and listening to low-frequency sounds emitted by a patented medical device. After a sprain, it helps to relieve the AMI (arthogenic muscle inhibitions) put in place by the brain to protect the joint, and to overcome the stages of rehabilitation.
In practical terms, after a sprain, the fibular often present a inhibition at two levels: a strength deficit (reaction time too long) and an alteration of contraction sequences with the others stabilizersHowever, at heel-to-ground contact, the fibularis muscles must ensure a pre-contraction ensuring the external stability of the ankleAllyane therapy aims to reassign the peroneal muscles (strength and function) and to reprogram these sequences of muscle activity. Integrated into the protocol of physiotherapyIt allows for faster treatment and optimizes functional procedures (a key issue for...) athletes) and to provide a solution for patients suffering fromchronic instability which no longer evolves after a year. It serves to enhance the re-education conventional, without replacing it.
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