Ankle Sprains; A Common Tennis Injury

Over 2,000,000 severe ankle sprains diagnosed in emergency rooms throughout the United States every year. How many times have you had a pretty bad ankle sprain and not gone to the ER? That accounts for hundreds thousands if not millions more ankle sprains per year that are left out of this ER statistic. Ankle sprains are one of the most common musculo-skeletal injuries during recreational sports, especially amongst tennis players. You don’t see too many serous knee injuries occur during a tennis, match, but ankle sprains are common. Why is that so? Well the answer to that is a longer one and I will address it in another post, but I just wanted to give you some tips if you did happen to sprain your ankle.

I.C.E.R.R.S.S. is a version of RICE that we have all heard, which is very good advice, but I wanted to take it a few steps further.

1) Ice-as soon as possible after a sprain (or damage to a ligament). Getting ice on a sprain within 5 minutes of the initial injury may decrease healing time by up to 50%! Following a cycle close to 20 minutes on and 30 minutes off works well. Make sure the ice is in a towel or cloth and does not touch your skin directly, it can damage the skin (frostbite!). I find that mashing up the ice before I put it in a bag or using an ice pack helps to contour the ice to my ankle, it tends to stay on better and get to the source of the injury faster. My personal favorite is an ice-bath. I take a small garbage can (clean of core) or plastic bin that my foot can fit in and goes up pretty close to my knee and fill it 1/2 way with cold water, then dump in 2 or so trays of ice cubes. Put a towel down on the floor for spills, set the bin down next to the couch or a chair, put the injured foot/ankle in the tub and enjoy! THIS WILL BE COLD! Suck it up for 3 minutes then take the foot out for 5-10 minutes and repeat this cycle 2-4 times. Towel off and enjoy the reduction in pain and swelling!

2) Compression– wrap it up from just behind the ball of the foot to 4-6 inches above the ankle. An ace bandage works well here. The wrap should be firm and comfortable, it is not to provide support but to keep swelling down. This will help to reduce pain and help you fit into your sneakers:)

3) Elevation– sit back relax and put your feet up! Seriously, elevate the injured ankle above your heart if possible. This will help to keep swelling and pain down.

4) Rest-not secret here, just stay off it as much as possible for a day or two. It pain or swelling persist, go see your physician or licensed health care practitioner (physical therapist, Osteopath, chiropractor, athletic trainer etc.) and get check out.

5) Recovery– postpone that hike up the 14’er you were planing or level 6 tennis tournament for a week or two, if not longer depending on how severe your sprain is. Just because it feels better, and the swelling is down, does not mean it is better. The ligaments will take months to finish being repaired with scar tissue and will NEVER return to their original strength. That’s right NEVER. This does not mean that you can not return to form or improve at your athletic endeavor, just realize that injuries are permanent to some degree, especially injuries to ligaments and will stay with us somehow for ever.

6) Stretching-yes, muscles get tight when you just lay around with your foot up (or over use them). So lengthening the lateral gastroc and peroneals will be part of the program here. the tend to tighten up or splint when there is an injury and you will want to calm them down with a soft tissue technique like self-myofascial release. The hip flexors and low back may get tight too from limping around as well…

7) StrengtheningYes! After ankle sprains the glutes tend to “shut off” and they need to be activated and returned to active duty. Addressing the peroneals and other muscles around the ankle will be important as well. The glutes ate the power house for walking, running and jumping. We better get them back on line!

A note on manual/physical/physio therapy. I would recommend this 100 times out of 100 after a sprain even if you think you don’t need it. You don’t want to pick up any bad habits or faulty mechanics that will stay with you over time and cause more problems.

Gotta run!

Thank you for reading and remember to I.C.E.R.R.S.S. after you sprain your ankle next time!

Eric Beard
Corrective Exercise Specialist
Athletic Performance Enhancement Specialist

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