Can an Ankle Sprain Lead to Bigger Problems? A Look at the Complex Rehab to a Common Injury.

Ankle Sprains should not be taken lightly, and can lead to long term disability if not addressed properly.

A Common Injury doesn’t guarantee an Easy Recovery

Ankle sprains are one of the most common musculoskeletal injuries, affecting both athletes and non-athletes, leading to an overwhelming amount of urgent care visits and disability. But you may have heard someone say, "Oh, it's just a sprain," or “You just twisted your ankle, no big deal,” however the reality is that ankle sprains can be quite complex. They require proper rehabilitation to avoid complications and prevent recurrent injuries / happening again. If you’ve ever sustained an ankle sprain, you know how frustrating the recovery can be. But did you know that if not properly addressed, a simple ankle sprain can lead to other secondary injuries?

Ankle Sprain Injury Statistics

Ankle sprains are more common than most people realize. Studies estimate that around 23,000 people sustain an ankle sprain EACH DAY in the United States. They account for about  45% of all sports-related injuries, and up to 73% of individuals who suffer an ankle sprain will experience recurrent sprains. Clearly, this is not just a minor inconvenience but rather can be considered a significant health concern.

Understanding the Anatomy of the Ankle

The ankle is a complex joint, involving multiple bones, ligaments, and muscles. Understanding its anatomy can help explain why some injuries are more severe than others.

• Bony Joint Complex: Includes the talus, tibia, and fibula, as well as the proximal tibiofibular joint (this is near the outside/below the knee joint).

• Ligamentous Anatomy:

  • Lateral Group: Most commonly injured in inversion sprains.

  • Deltoid Group: Located medially and involved in eversion sprains.

• Other soft tissue structures (muscles) that can be affected in an ankle sprain.

  
  

Sprain vs. Strain – What’s the Difference?

Have you used these terms interchangeably when talking about your injury? Does it really matter? Yes, yes it does matter - let me explain:

A sprain occurs when ligaments (which connect bones) are overstretched or torn - thus a sprain is an injury to the ligament. A strain, on the other hand, affects muscles or tendons (which connect muscles to bones). Sure, it is more often that both structures are both injured to a certain extent, causing both a strain and a sprain simultaneously. But understanding this difference is key to proper treatment and recovery, as the rehab strategy for each injury is significantly different. 

A “Simple Sprain” Doesn’t Mean an Easy Recovery

Despite how common ankle sprains are, they should not be taken lightly. Many people assume that once the swelling and pain subsides, they are good to go—but without proper rehabilitation, the risk of reinjury increases significantly. Recurrent ankle sprains can lead to chronic instability, altered movement patterns, and even secondary injuries in the knee, hip, or lower back.

What Causes Recurrent Ankle Sprains?

Some of the most common reasons people experience repeated ankle sprains include:

• Proprioception issues: Your body’s ability to sense joint position can be disrupted after an ankle sprain, increasing the likelihood of rolling your ankle again.

  • Believe it or not, you can actually retrain and “strengthen” your the proprioceptors in  your ankle to reduce this risk.

• Sports or traumatic injury: High-impact, plyometric sports like basketball, soccer, and trail running put added stress on the ankle joint and increase likelihood of reinjury.

• Glute weakness: Weakness in the glutes/hips can lead to faulty gait (walking) mechanics throughout the lower kinetic chain, making the ankle more vulnerable to injury.

The Three Types of Ankle Sprains

There are three primary types of ankle sprains. We’ll break each one down in detail later, but for now, here’s a quick teaser:

1. Inversion Sprain: The most common type, often called "rolling your ankle."

2. Eversion Sprain: Less common, but involves injury to the medial (inner) ankle due to the structure of the lateral malleolus (the bony protrusion on the outside of your ankle).

3. High Ankle Sprain: Affects the syndesmotic ligaments between the tibia and fibula, typically occurring in high-impact sports.

   
   

Other Diagnoses to Consider

Not all ankle injuries are sprains. Some conditions present with similar symptoms but require very different treatments. Possible alternative diagnoses include:

• Tarsal Tunnel Syndrome: A nerve compression condition in the ankle.

• Fractures (Most commonly to the lateral malleolus): Identified using the Ottawa Ankle Rules to determine if an X-ray is needed.

• Evertor Muscle Strain: Involves overstretching of the evertor muscles rather than ligament damage.

• Jones Fracture: A break at the base of the fifth metatarsal, often mistaken for an ankle sprain.

• LisFranc Injury: A more severe midfoot injury that can mimic a sprain.

  
  

The Three Types of Ankle Sprains Explained

1. Inversion Sprain

• Most common type

• Happens when the foot rolls inward, overstretching the lateral ligaments

• Occurs in sports like basketball and soccer

2. Eversion Sprain

• Less common due to the bony anatomy of the lateral malleolus

• Happens when the foot rolls outward, stressing the deltoid ligament

• Can take longer to heal than an inversion sprain

3. High Ankle Sprain

• Involves the syndesmotic ligaments between the tibia and fibula

• Common in football and hockey due to twisting motions

• Requires a longer recovery period compared to the other types

Why RICE is an Outdated Treatment Approach

For years, the standard treatment for ankle sprains was RICE (Rest, Ice, Compression, Elevation). Then the RICE approach tried to update to “PRICE” (Protection, Rest, Ice, Compression, Elevation) However, newer research suggests that early mobility leads to a two-week faster return to pre-injury function without increasing the risk of reinjury. Resting too much can actually slow down healing and prolong recovery times.

The Osteopractic Approach to Ankle Sprain Recovery

At Flow Physical Therapy and Wellness in Lafayette, LA, we use an evidence-based, osteopractic approach to ankle sprain rehabilitation. Our treatment strategies include:

• Manual Therapy: Joint mobilizations, Cupping/Scraping/Massage, Stretching to improve movement and reduce pain. These techniques may be performed at the ankle - but also the knee and hip if necessary.

• Lower Extremity Strengthening: Including glute strengthening and balance work, which plays a crucial role in preventing recurrent ankle sprains.

• Electric Dry Needling: Used to stimulate ligament healing and reduce pain.

  
  

Why Glute Strength Matters

Many people don’t realize the strong connection between ankle stability and glute strength. Weak glutes lead to poor lower body mechanics - notably with heel strike during walking, increasing the risk of both initial and recurrent ankle sprains. Strengthening the glutes can improve movement patterns and reduce the risk of reinjury.

Ready to Get Back on Your Feet?

If you’ve been dealing with lingering pain and dysfunction from an ankle sprain and want to recover faster, don’t rely on outdated treatment methods like RICE. At Flow Physical Therapy and Wellness in Lafayette, LA, our expert Osteopractic treatment approach can help you regain full function and prevent future injuries.

Click the button below to book an appointment today and take the first step toward a stronger, more stable ankle!

Click Here to Get Started!

Dr. Patrick Thompson, PT, DPT, OCS, Dip. Osteopractic, FAAOMPT

Owner of Flow Physical Therapy and Wellness

337-366-1703