A sprained ankle can be abominably painful and minimally troubling, or minimally painful and abominably troubling with prolonged pain in the ankle.

There are varieties of ankle sprains:

• Lateral ligament strain but stable.

• Lateral ligament tear but stable.

• Lateral ligament tear but unstable.

• High ankle sprain.

• Ankle strain but boney bruising.

All are treated differently.

Do I need a Moon Boot and crutches?

A thorough assessment can work out if you need a motion based programme or immobilisation with or without crutches. Unnecessary immobilisation in a Moon Boot may delay return to function or sport but a missed ankle that needs immobilisation may lead to chronic ankle instability.

Some hints that might point towards necessary immobilisation include:

• Inability to weight bear or walk.

• Excessive laxity on ligament stress tests.

• Acutely tender around the ankle joint bones.

Do I need an X-ray or Ultrasound after spraining my ankle?

Patients often walk in with ultrasound or x-ray results in hand after being referred by their GP. However, this doesn’t mean you need scans before coming in.

Our Physiotherapists can assess your ankle to determine whether imaging is necessary for you too. We will refer you to your GP for scans if we think further investigation is necessary. In some rare cases, imaging will visualise ligamentous injury that aren’t correlated by our clinical tests - i.e. “My scan says I have a grade 3 tear of my ATFL” - but when we test it, your ankle isn’t loose. Go figure.

Not your “garden variety ankle sprain”

Some patients will progress through a rehabilitation plan post ankle sprain, but their pain or feelings of instability doesn’t resolve as expected. You may not have a garden variety lateral ankle sprain. These conditions may require extended rest or immobilisation in a boot or further exercises.

Conditions in this category include:

• Talar dome osteochondral lesions (boney bruising)

• Post traumatic synovitis (angry joint capsule)

• Anterior or Posterior Impingement

• Chronic ankle instability (CAI)

• Sinus Tarsi Syndrome

More information on these conditions coming soon…