Ankle sprains – 2018 Update
Heres a blog that would be relevant to most people who have played a multi-directional sport at some point in their lifetime!
Ankle sprains are the most common lower limb injury for sports people and have the
highest re-injury rate of all musculoskeletal injuries. Last year in 2018 the British Journal of
Sports Medicine (BJSM) updated their clinical guidelines on how to assess and manage
lateral ankle sprains, they emphasised the need for early mobilisation and rehabilitation for
ankle sprains with no bony pathology – this is where Osteopathy can really make a
The swelling that occurs in the early stage of an ankle sprain can significantly reduce the
patient’s range of motion (ROM) and often causes pain, Osteopathic manual therapy
techniques have been shown to be effective in regaining this lost ROM. Manual therapy
techniques that an Osteopath may use include: effleurage, where the aim is to reduce
excess oedema in the ankle; soft tissue massage, to reduce tight muscles that impact joint
function; joint manipulation or mobilisation, to increase ROM in the ankle and foot joints.
When combined with an adequate exercise program the BJSM guidelines recommend that
manual therapy has a strong role to play in providing optimal treatment and management
of ankle sprains.
Exercise prescription of ankle sprains can be broken down into 5 stages:
Stage 1: Regain range of motion.
Exercises such as ankle flexion exercises and lunges, coupled with manual therapy
are effective ways to achieve this.
Stage 2: Regain balance and proprioception.
This can be done once weight bearing becomes tolerable. Exercises such as bosu ball
balance and side lunges will help in this stage, as well as graded introduction into
relevant, low intensity sports activities.
Stage 3: Strengthen lower leg muscles
An effective strengthening program should target the extrinsic stability system
including the soleus, gastrocnemius, tibialis anterior and posterior, peroneals, and
intrinsic foot muscles.
Stage 4: Start sports specific exercises (return to modified training).
With the aid of taping or bracing, begin graded exposure to sports specific training.
Depending on the sport this may include running, umping, swimming or ball-
Stage 5: Return to sport
With the aid of taping or bracing, return to full training and then return to gameplay.
Keep monitoring the ankle for flare-ups and continue to strengthen the ankle to
Dr Ash Smith has a wealth of knowledge with sporting injuries, working with various Netball,
Volleyball, Aussie football, and Soccer teams over the years both on game day and in the
clinic. He has a strong focus on Exercise Rehabilitation as coupled with his Osteopathic
He is currently available Tuesdays 3-8pm and Thursdays 7am-12pm
Book Online: www.osteopathicmovement.com
Call: 0402 377 209