Emergency and Urgent Care - Ankle Injury Advice

What is an ankle sprain?

An ankle sprain is a common injury, often caused when the ankle is forced to bend more than normal. This stretches the ligaments and soft tissues that hold the ankle and foot bones in place.

What are the symptoms?

• Mild ache to sudden pain
• Swelling
• Bruising
• Inability to move the ankle normally

How is it treated?

P - Painkillers: it is important that you take regular painkillers to reduce the pain and help you keep moving around. Paracetamol and ibuprofen are effective painkillers if they are taken regularly and can be taken at the same time. These medications can be easily purchased over the counter at supermarkets and pharmacies. Please carefully read the instruction leaflet with the medication and only take the recommended dose; there may be reasons why you cannot take these medications, a pharmacist will be able to help you with this.

R - Rest: will help prevent further injury and allow the healing process to begin. For the first 2 days reduce the amount of walking you do and gently exercise your ankle to prevent stiffness. Avoid forceful and strenuous activity, such as running, until you can walk without it causing pain.

I - Ice: can help reduce swelling and reduce pain. Make an ice pack by wrapping a small bag of frozen peas or some crushed ice cubes in a damp towel – DO NOT put ice pack directly onto skin. Put the ice pack on the ankle for up to 20 minutes every 2 hours for the first 3 days after the injury. Then use the ice pack 3 times a day until the swelling has gone down. DO NOT eat food that has been thawed and refrozen.

M - Mobilisation: early weight bearing (putting weight on your injured leg) has been shown to help sprained ankles to heal more quickly. This is why most people with an ankle sprain will not be given crutches. Always try to walk normally, with your heel striking the floor first, then rocking forward onto your foot and pushing off with your toes. Using the exercises in this leaflet will help you to regain movement and build up strength and balance in your injured leg.

E - Elevation: keeping your injured ankle raised above the level of your hips for the first 2 days after your injury. This will help to decrease the swelling and pain.

Compression: We no longer offer compression bandages for sprains, because they appear to have no beneficial effect on how quickly or fully you recover.

What to Avoid:

H - Heat: hot baths, saunas and heat packs will increase swelling and bleeding.
A - Alcohol/Smoking: reduces healing and increases swelling and bleeding.
R - Running: or any form of weight bearing exercise which may increase further activity.
M - Massage: may increase swelling and bleeding.

Recovery

Healing of the ligaments normally takes about 6 weeks, although everyone recovers from injuries at different rates. Healing time is related to how severe your injury is and any other medical problems you may have.

As healing gets underway, it is important that you begin a series of exercises to help you get back the full use of your ankle by improving its flexibility and strength. This will help to reduce the risk of further sprains

Returning to physical activity

• Returning to sport and work will depend on the demands of your job or chosen sport
• Recovery is faster if you stay at work, or go back to work as early as possible
• If you are on your feet all day you may need to gradually return to work, do light duties initially, or have regular breaks to elevate your leg
• Once you have regained movement, strength and balance you can slowly start to increase your activity back to your previous level

Driving

It is important that you contact your insurance company to let them know about your injury. You may be able to drive once you are able to perform an emergency stop safely and fully operate your vehicle.

Exercises

• These exercises will be most effective if completed “little and often”
• They can be done every 2 hours
• Start exercising slowly and build up gradually
• Pain can increase initially but will soon settle down within a few days of starting the exercises
• Consider appropriate footwear – supportive shoes or lace up boots that go above the ankle are recommended

Movement

Sitting down, move you foot/ankle:

• Up and down 10 times
• Left and right 10 times
• Write the alphabet 10 times

Balance

Using a kitchen counter, table or back of chair for support:

• Stand on the injured leg for 1 minute
• Repeat 3 times

Calf Stretches

Sitting down on the floor or bed:

• Hold a towel in both hands and place underneath your foot
• Pull the foot towards you to stretch your calf and hold for 30 seconds
• Repeat 5 times

Standing on a step, let your heel drop down over the step to stretch your calf:

• Hold the stretch for 30 seconds
• Repeat 5 times

Strengthening

Hold onto a table, kitchen counter or back of a chair:

• Push up onto your toes so that your heel raises up off the floor
• Hold for 5-10 seconds
• Repeat 3 times

Whilst sitting, place a band around both feet:

• Keep your GOOD leg still
• Keep heel on floor and move BAD foot/ankle outwards
• Hold for 5 seconds
• Repeat 3 times

Physiotherapy

If you are unsure about what to do and feel you need support with your rehabilitation, then you can always go to see a Physiotherapist.

If you live in the Heywood, Middleton and Rochdale area, you can refer yourself by using the following link:
www.physiodirect.northerncarealliance.nhs.uk

Things to watch out for:

See your GP or a Physiotherapist if you experience any of the following:

• You get bruising on the sole of your foot
• Your pain is getting worse not better after 2 weeks
• You get numbness or pins and needles in the injured ankle that has not improved after 2 weeks
• You continue to injure your ankle or go over on it repeatedly and you don’t trust it
• You are not back to normal after 6 weeks

Work

If you do not feel capable of working either due to pain or reduced movement/mobility, you are able to self-certify sickness for the first 7 days.

You must complete a self-certification form found on the government website and give this to your employer. This entitles you to statutory sick pay from your employer for up to 7 days.

To access the self-certification form, follow this link:
https://www.gov.uk/government/publications/statutory-sickpay- employees-statement-of-sickness-sc2

If you feel you need longer than 7 days off work, you must contact your GP for a sick note. The Urgent Treatment Centre does not issue sick notes.

For further advice or information please contact NHS 111 via telephone or on their website, or contact Rochdale Urgent Treatment Centre on 01706 517023.