WHAT SCIENCE CAN DO TO HELP?
This article uses peer reviewed, published journal sources to compile the ultimate guide to recovering and rehabbing an injured ankle. We look at the effectivity of medication, support, exercise, physio and look to determine how you should consider the recovery process for ankle injuries.
Whilst everything here is sourced from peer reviewed journals, we are not your doctor and you should never take the advice of someone on the internet at face value. Before putting any rehab into practice, give your doctor or physio a shout and confirm that the advice here is right for you.
DOES MEDICATION HELP ANKLE REHAB?
The tricky question to start with, should you medicate? The commonly held belief is that taking painkillers can do more harm than good, as they turn off the natural signals that your body gives you that allow you to prevent re-injury. Whilst this is certainly the case, there is good evidence that the use of non-steroidal anti-inflammatory drugs (ibuprofen for example) during the first 2 weeks following ankle sprain is an effective way to kick start recovery.
Whilst there has been only one study that followed patients for a longer period; it reported that Piroxicam (a prescription based NSAI) taken for 1 week significantly improved ankle rehabilitation results at all times up to 6 months. However, the study also reported that in the short-term people on the anti-inflammatory had more minor mobility issues.
We like to think in the long term, and as long as you are careful with your training and rehab programme, you should consider taking anti-inflammatories. Whilst they are not a miracle cure, they can do a lot of good (as long as your doctor is happy with you taking then).
Working the injury out is a key part of rehabilitation, three individual studies have proven that exercise results in less risk of recurring ankle sprains. In the largest study we could find (with over 500 participants), discovered that adding balance exercise and stretches to a rehab routine showed good results, concluding that stretching exercises were a fantastic idea for people looking to recover from ankle injuries.
USING SUPPORTS TO AID ANKLE INJURY RECOVERY
The rehabilitation and recovery process can be a huge drain on your body, people report that chronic pain, impaired movement and the sensation of the ankle giving away under pressure. The main way of preventing these has always been said to be by using external supports, but does the journal evidence back this up?
Quite simply, yes it does!
We found two well designed reviews focusing on the use of ankle supports and both of them concluded, with strong evidence, that the use of supports during sporting activity results in a decreased risk of the ankle sprain reoccurring.
The Bearhug Sports support is perfect for this, as functional support (where you can move your ankle around) is better than immobilisation for most ankle sprains. Benefits of functional support included a higher percentage of people returning to sports, shorter time to return to work, less swelling, and greater range of motion. The unique design of the Bearhug gives you the support you need, paired with the comfort required to wear for periods of exercise; without the risk of slipping, moving (which can cause more injuries to occur).
DO ELECTRO-PHYSICAL AGENTS WORK FOR ANKLE REHAB
Electrotherapy or Electro Physical Agents (EPA) is a modern method which some are experimenting with to help ankle injury recovery. Some examples of EPA are
- Therapeutic Ultrasound frequency.
- TENS or Transcutaneous electrical nerve stimulation
- EMS (Electrical Muscle Stimulation) or NMES (Neuro-Muscular Electrical Stimulation)
They sound complex, right? Well- in reality it is a case of using existing technology in an attempt to treat injury.
Sadly however, journal evidence doesn’t back up the anecdotal claims made about EPA.
Ultrasound does not appear to be effective although the studies are far from exhaustive, there may be some untested benefits. In one study, low-level laser treatment, coupled with rest, ice, compression, and elevation (RICE) was shown to reduce swelling more effectively than just RICE for up to 3 days after the treatment when commenced within 8 h of injury and given twice a day.
Great news for ankle injury sufferers! Or…Maybe not, as another study showed that neither high nor low-level laser was more effective than placebo in reducing pain. In this study, the placebo group actually performed better.
EPA can be really expensive, but if you want to stop at nothing to aid your recovery it might be worth taking the plunge. As it stands though, we can’t recommend it until there is something tangible we can get our teeth stuck into in a journal!
Journal evidence clearly states that your ankle rehabilitation plan should involve three individual elements:
- Stretching, balance and mobility exercises
- Use of a support, such as the Bearhug Ankle
- The consideration of taking anti-inflammatory drugs – we do however suggest that you ask your doctor before doing so and always read the label!
If you want to kick start your recovery, check out our ankle support, the journals say it is a good plan! If you want some less light reading; take a look below for the sources we used to put this all together.
Ogilvie-Harris DJ, Gilbart M. Treatment modalities for soft tissue injuries of the ankle: a critical review. Clin J Sport Med 1995;5: 175–86
McKeon PO, Hertel J. Review Systematic review of postural control and lateral ankle instability, part II: is balance training clinically effective? J Athl Train. 2008 May-Jun; 43(3):305-15.
van der Wees PJ, Lenssen AF, Hendriks EJ, Stomp DJ, Dekker J, de Bie RA. Effectiveness of exercise therapy and manual mobilisation in ankle sprain and functional instability: a systematic review. Aust J Physiother. 2006; 52(1):27-37.
Hupperets MD, Verhagen EA, van Mechelen W. Effect of unsupervised home based proprioceptive training on recurrences of ankle sprain: randomised controlled trial. BMJ. 2009 Jul 9; 339():b2684.
Aaltonen S, Karjalainen H, Heinonen A, Parkkari J, Kujala UM. Prevention of sports injuries: systematic review of randomized controlled trials. Arch Intern Med 2007;167: 1585–92
Handoll HHG, Rowe BH, Quinn KM, de Bie R. Interventions for preventing ankle ligament injuries. Cochrane Database Syst Rev 2001;3: CD000018.
Kerkhoffs GM, Rowe BH, Assendelft WJ, Kelly K, Struijs PA, van Dijk CN.Immobilisation and functional treatment for acute lateral ankle ligament injuries in adults. Cochrane Database Syst Rev. 2002; (3):CD003762