Suffering an ankle injury can be a really painful and frustrating experience. It is a typically common injury which is often difficult to manage due to how long it can take to resolve.
Ensuring you get the right advice, education and care is always a great way of helping to assist the healing process.
Sprained ankles can happen during sporting activities and everyday life. You could roll over your ankle on an uneven surface in the street as equally as you could hurt yourself playing sport.
A key part of the healing and rehabilitative process is to get the ankle strapped as early as possible to help the ankle heal.
There is a good research to show that early strapping help to stabilise the ankle and promote better healing.
This guide today will look at some of the basics of ankle sprain management but also how and what you will need to strap an ankle correctly to ensure you get the best chance of recovery.
How do you sprain an ankle?
Sprains happen when a joint is taken beyond its limit, causing the tissue to become overstretched and torn, causing damage.
There are many ways in which this can happen such as:
- Trauma and impact
- Not being warmed up and sudden movement applied to a muscle or joint
- Twists, Slips, Trips.
- Overuse of a muscle or joint
There’s some of these things that we simply can’t do anything about such as bad tackle or challenge in football, or impact in combat sports. A good warmup and physical preparation plan can limit your chances of suffering an injury.
In everyday life, common scenarios that typically result in ankle sprains are from footwear choice and uneven surfaces – such as high heels. They aren’t the most practical of shoe and do not provide good stability at the best of times. Uneven floors or weather conditions can often cause slips, trips and falls, again which are all unavoidable.
What is a sprain?
A sprain is a ligament injury which involves trauma to the joint.
Ligaments are the tissues which hold bones to bones and typically occur with impact, twists and over extension injuries to body parts.
Here is the grading system for sprains.
Grade I – structural damage only on microscopic level, with slight local tenderness and without joint instability.
Grade II – partial tear (rupture) of the ligament, visible swelling and noticeable tenderness, but without joint instability (or with mild instability).
Grade III – a severe sprain: complete rupture of the ligament with significant swelling and with instability of the joint.
Mild sprains will recover in around 6 weeks – more serious sprains can take 3 months or more. Each injury is individual and you should contact a professional for help in assessing your injury and recovery time.
To simplify things we will look at the main bones, joints and ligaments of the ankles as these are the structures that are affected in a sprain injury:
The ankle joint is formed by three bones; the tibia and fibula of the leg, and the talus of the foot.
The tibia and fibula are bound together by strong tibiofibular ligaments. Together, they form a socket, covered in hyaline cartilage which is smooth and allows for easy movement of the ankle joint.
The body of the talus fits perfectly on to the bones of the leg. The articulating part of the talus is wedge shaped – it is broad at the front, and narrow at the back.
There are two main sets of ligaments which sit around the bony points of the ankles known as the malleolus.
Medial Ligament – which is on the inside of the ankle.
The deltoid ligament is attached to the medial malleolus which sits on the inside of the tibia.
It consists of 4 ligaments, which fan out from the malleolus, attaching to the talus, calcaneus and navicular bones. The primary action of the medial ligament is to resist over eversion of the foot.
Lateral Ligament – The lateral ligament is a name for the complex of ligaments. They originate from the lateral malleolus which is the bony prominence on the outside of the ankle or fibula bone. It resists over-inversion of the foot which is when your foot can roll over.
Anterior talo fibular – attaches between the lateral malleolus and lateral aspect of the talus.
Posterior talo fibular – attaches between the lateral malleolus and the posterior aspect of the talus.
Calcaneo fibular – attaches between the lateral malleolus and the calcaneus.
The ankle moves in 4 main directions which are:
- Plantarflexion – pointing of the foot downwards
- Dorsiflexion – pulling of the foot upwards.
- Inversion – movement of the foot inside, causing the ankle to move laterally.
- Eversion – movement of the foot out over, causing the ankle to move medially.
What can I do when I have sprained my ankle?
There is a new acronym which can now be used as part of guiding your recovery from a sprained ankle, it has been updated with all the latest evidence.
The big changes are that ice is out – it is no longer found to be helpful for reducing swelling/inflammation and it has even been shown to delay the healing process.
There is also an update to how we manage injuries that incorporates our mental health:
The first section PEACE is for immediate management, LOVE is for ongoing care and rehab.
- P for Protection,
- E for Elevation,
- A for Avoid anti-inflammatory modalities,
- C for Compress – use of strapping and taping is recommended
- E for Educate – seek knowledge on your injury
- L for Load – manage the weight and activity you do
- O for Optimism – stay positive
- V for Vascularisation
- E for Exercise – pick the right type at the right time.
The science and research is constantly changing within all of healthcare and injury management changes to. This is the latest and most practical way of managing an ankle sprain. Gone are the days of rest, ice and pain killers. In are the days of active rest, compression and early mobilisation.
One of the key points noted in the first section is compression. This can be achieved with taping and strapping which also allows us to load the joint optimally and help us return to exercise sooner.
How to correctly strap you sprained ankle
What will I need to strap my ankle?
This is a broad question and it really depends on how you would like your ankle strapped and also the severity of your injury and which stage you are at in your injury.
Without question you will need a good foam under wrap which will act as an underlay and help to protect your skin from any adhesive and stop those hairs from getting ripped out. It also makes the strapping more comfortable.
The choice of tape next can vary: if you are looking for a more restrictive taping then go for zinc oxide tape which is often none stretching, firm in nature and helps to restrict movement. This will be best utilised in an ankle sprain that is severe and in the early stages which requires immobilisation and added stability. Zinc oxide tape can be bought in different thicknesses and it can often be handy to have the thicker and thinner varieties when strapping an ankle.
Elasticated Crepe Bandaging
This is ideal for when the ankle needs support but the ankle can move a bit more freely. This strapping can also be utilised within the early stages of injury but it does allow more movement. Overall it is very easy to strap with and very comfortable for the person to wear. Other tapes can often be difficult to remove. Elasticated bandage is great for achieving a smooth finish on the strapping.
Provides the least support to an ankle injury. What it is excellent for however is giving feedback to the person and providing a gentle reminder as to how their ankle is moving. This tape is often placed on in strips with added tension to provide light support and the elasticity helps to create a tension which supports the ankle during rehabilitation and aids in the correction of the ankle stability and balance.
Ankle Strapping Technique
There is no wrong or right way to strap an ankle – as mentioned before, it totally depends on what stage of the injury the ankle is at and how severe it is and finally what stage of recovery the ankle is at.
If the ankle needs strapped for protection and in an early stage of healing, the best technique is as follows:
- Foam under wrap
- Anchor straps of zinc oxide around the lower leg and the mid foot
- Supportive straps of zinc oxide crossing over the ligament regions to provide added reinforcement
- Crepe, elasticated bandage over the top to provide a neat finish, compressive nature to aid swelling and to protect the rest of the taping.
If the ankle requires strapping for exercise and rehab where movement is required:
- Foam underlay around the ankle and foot.
- Crepe bandaging applied around the bottom of the leg
- Crepe bandaging around the mid foot
- Crepe bandaging applied in a cross motion to link the foot and ankle and add stability.
If the ankle requires the least support as possible and just needs some gentle reminders regarding its stability during end stage rehab:
- Take 2 strips of kinesiology tape
- Apply an anchor point to the outside of the shin, stretch tape down and anchor underneath foot
- Apply an anchor point to the inside of the shin, stretch tape down and anchor underneath the foot.
These are simple, brief guides to taping. If you are unsure of how to do the taping described above, there are some attached videos which can help you to understand the taping process.
Failing this and you are finding it hard to do yourself, visit a physiotherapist who will be able to strap the ankle for you for a minimal fee and this will help you to gain the technique so you can strap your ankle.
This could be a worthwhile investment due to the length of time an ankle injury can extend for.
That concludes our guide to ankle sprains and how to tape them. This again is a brief overview which looks to provide you with the basics and underpinning knowledge which can help you make an informed decision.
Strapping of the ankle and injuries should always be managed following professional advice and care if required to allow the best possible recovery.
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