Chiropractic and the Grade 1 Ankle Sprain
I’d be surprised if you’ve never sprained your ankle. Most people have to some degree and as Chiropractors, we manage these quite often.
Hi, this is Dr. Andrew Arnold, Chiropractor at Back In Motion, Cranbourne.
Today, I want to talk about how Chiropractors can help treat and manage ankle sprains.
Let’s start by talking about anatomy.
There are 22 bones in the foot and 140+ muscles, ligaments, tendons, and joint tissues from the ankle down. That’s a lot of combinations and permutations of different things that can go wrong.
Now let’s look at the severity:
Essentially there are 3 grades. All 3 grades involve damage to ligaments which causes the joints to not work as they should. A sprain refers to ligaments and, in all cases, involves a tear albeit microscopic.
According to the University of Michigan (https://www.uofmhealth.org/health-library/te7663 )
In an ankle sprain, damage to the ligament varies from simply stretched or slightly torn to completely torn. Your doctor will grade your sprain accordingly:
- Grade I is stretching or slight tearing of the ligament with mild tenderness, swelling, and stiffness. The ankle feels stable, and it is usually possible to walk with minimal pain.
- Grade II is a larger but incomplete tear with moderate pain, swelling, and bruising. Although the ankle sometimes feels stable, the damaged areas are tender to the touch, and walking is painful. See a picture of a grade II ankle sprain.
- Grade III is a complete tear of the affected ligament or ligaments with severe swelling and bruising. The ankle is unstable and may feel “wobbly.” Walking is usually not possible because the ankle gives out and there is intense pain, although initial pain may quickly subside.
A grade 1 sprain typically presents with the patient being too able to walk into the practice; they may have a slight limp; there may be bruising and swelling although this may take a few days to come out. A grade 1 sprain may take a week to 10 days to heal.
A grade 2 sprain presents as a more marked limp, bruising and swelling. This person may be able to walk into the clinic or may need crutches. They most likely cannot stand up on toes or heels without pain. Healing time 2-4 wks.
A grade 3 is a complete ligament rupture and may require casting, a moon boot, or even surgical intervention. Healing time 4-6wks +++.
In our practice, we manage grade 1 sprains. Grades 2 and 3 need to be referred to podiatrists, orthotists, GP’s, and surgeons.
The Chiropractor is able to differentially diagnose grades of ankle sprain with physical examination, radiological exam, tuning fork testing for fracture, and appropriate referral for further testing via the GP.
Chiropractic management of a grade 1 sprain:
Microscopic tearing of ligaments and joint tissues causes joint fixation and dysfunction. Our job as Chiropractors is to help restore motion as soon as possible. This helps promote circulation which helps to heal.
In our practice, we use mechanical aids. These include the Activator, the Neuromuscular impulse device, and the drop board. All 3 tools are safe, effective, and gentle. They help restore motion quickly which boosts both the nerve and blood supply and these speeds up healing. We may also use ultrasound and interferential, which are electro-therapies also designed to speed healing. Finally, we may prescribe inserts and tape the foot and ankle, alongside rehabilitative exercises.
In conclusion, the Chiropractor is well placed to manage Grade 1 ankle sprains.
About the Author:
Dr. Andrew Arnold is a Chiropractor and director of Back in Motion Cranbourne.