Massage therapy for a Sprained Ankle; as therapists what do we need to be aware of, when should we work on a sprain and the massage techniques to prevent future flair ups.
What muscles and ligaments are involved?
Let's take a look at the surface anatomy for a lateral ankle ligament sprain...
With a sprained ankle we are looking at a lateral ankle ligament sprain although the problem can also be compounded by tightness in the soleus and gastrocnemius. Another consideration is that whilst the injury may be located in the ankle, the muscles all the way through the legs to the pelvis are going to be working harder to stabilise the leg. There is potential for pain referral up to the pelvis due to the persons gait altering as the person overcompensates; for example is glute medius being overloaded on one side?
Contraindications & when can you work on the affected area?
Your client should have consulted a GP to confirm their injury. As therapists we shouldn't be working on the area when the injury is acute. A great way to assess if the ankle is ready to be worked on is to hold the alternate ankle for 30 seconds noticing the warmth. Then hold the affected ankle for 30 seconds noticing whether it is hotter, therefore more inflamed and 'angrier' than the other. If you can notice a significant difference in temperature then avoid working on the area until it has calmed. It's always important that if you are left concerned by the severity of the sprain either from the way the client talks about the injury of the heat and inflammation you see it is always best practice to refer back to either their GP or A&E.
Applying ice to the injury is very good for pain relief, however bear in mind that inflammation is natures way of healing and by applying ice we are inhibiting and potentially slowing that natural healing process. If the injury is too acute to be treated there is still work we can do to the overworked areas that are compensating to stabilise the leg. This will also aid healing by encouraging a fresh blood flow to the site of the injury which will in turn speed up the rate of recovering.
Techniques to prevent future flair ups
With this type of sprain we often see clients complaining of repeat injuries or flair ups. When the injury is no longer acute we can start to relieve any tightness that remains in the ligaments to try to reduce any future issues. Here Chris Phillips, Principal of the Academy, shares some techniques to tackle tightness in the ankle ligaments...