T Nation

Rehabing Sprained Ankle


#1

On Mon. Was rolling with a guy in jiu jitsu. I don't know what the lock was but he had my ankle in either ankle lock or heel hook. He didn't have control of my leg, just the foot. Anyways... There was no pain but a huge giant loud pop. No pain. Everyone stopped. No swelling right away and realy no pain. Went to dr. To get it xrayed and looked at just in case. Nothing torn or broken/fractured. Dr said just a sprain and I should be back to normal soon. I couldn't believe it, because the sound was so loud. I compare the sound to snapping to giant dinosaur bones. Anyway I immediately icng it and kept it wrapped up and have done my best to elevate it. Long story short. There was some mild swelling. No more then golfball sized. Swelling has gone down. There is some bruising now. Anyways... I'm curious to know what should I do now. I'm extremely nervous to put 100% pressure on it and get back into class. Still limited ROM and soreness. What do I do next? Continue to ice and NSAIDS? Or heat now? What about exercises? And at what point do I go back to jiu jitsu class? Thanks brothers.


#2

Continue ice and compression until the swelling is gone. tape for lifting, dont do anything that requires balance (1 leg stuff, running etc).

You can work on Range of motion, and strength. After the swelling is gone, you can start heating it before you workout. But range of motion and stretching will be important to get back before you start working out again. (without full range of motion you can cause other injuries).

Once range of motion is bback work on balance as well.


#3

The "pop" you heard was most likely your talus shifting within the mortise joint space. I am assuming the injury occurred this past monday so it has been about a week now. What type of doctor did you see? GP or ortho? How did he/she determine that you did not have anything torn? XRays will only show bone structures, not soft tissue.

Where is you pain discomfort specifically? Where was your swelling? Is your ROM limited due to swelling, soft tissue restriction, or discomfort? Have you been walking on it or been on crutches? What have you been doing in terms of therapy/rehab?


#4

LevelHeaded:

  1. Yes The injury happened this past Monday. 1 week tomorow.
  2. I just sawa GP.
  3. He came to the diagnosis of a sprain from several x-rays and just some palpation and soft tissue examination and ROM tests.
  4. There realy isnt much discomfort. There realy wasnt any discomfort when it happened either. The mild discomfort I do notice is on the side by the ankle bone and maybe a little up the calf area. But again this is pretty mild and on a scale of 1-10 10 being extreme pain. Its a 1.
  5. The swelling was on the outside of the foot. Where the ankle bone sticks out. It was not much swelling. But it was definetely slightly roundeder and puffier. Also some mild swelling on the side of the foot. But this was minimal @ most.
  6. ROM initially was fine. As the day progressed and the swelling set in it did get more stiff. I havent realy tested the ROM much. I have been favoring the other side when I walk as to trying not to put to much pressure and stress on it.
  7. No crutches. R.I.C.E. 1st couple days walked with mild limp. Most of the limp was a concious limp as I didnt want to put to much pressure/stresss on the foot. Today minimal to no limp. but I am cautious especialy with making turns.
  8. No rehab as of yet. Just walking on it more and more each day. And allowing more bodyweight on it each day.
  9. There was some mild bruising along the base of the foot. But it was minimal.

What do you think?
should I try to get in with a pediatrist or just slowly go about things as I have been and work on some rehab exercises?

Also do you think I should ice still?
Should I ice after rehabing it exercises?

Thank you


#5

I dont think a pediatrist is necessary. If anything, it would be beneficial to see a physical therapist or athletic trainer.

You should never limp when walking, it just creates poor movement patterns and will create problems in other areas (hip for example). It does sound like a basic ankle sprain with a probably peroneal strain.

Being 1 week out of the injury, I really don't think excessive ice is necessary. If you want to do it to numb pain after activity, go for it, but it doesn't need to be as frequent as when the injury initially occurred. Focus on ROM of the ankle and strengthening of the ankle. Spell the alphabet with your foot, make big circles, etc. If you are able to get formal therapy, see if the therapist is familiar with ankle traction techniques. I have found those to be very beneficial with ankle sprains. Seeing as it seems like a mild ankle sprain from the info you've given, you can even probably begin some balance/proprioceptive work for your ankle.

Summary:
1) Stop limping
2) Ice after activity as you see fit - not necessary to ice all the time though this far into the healing process
3) Work on improving ROM and strength of ankle
4) Begin basic balance/proprioceptive work


#6

LevelHeaded.
Thank you very much.