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by Thomas Clennell, PT, DPT, SCS 

One of the most overlooked and nagging injuries in sports is the dreaded sprained ankle. It happens in almost all sports from football, to basketball, to soccer, to baseball. It does not discriminate by age, gender or sport. Current research places the incidence of ankle injuries at approximately 1 million per year with 85% of that being ankle sprains. The most commonly heard phrase in regards to an ankle injury has been “walk it off,” but for young athletes that may not always be the best idea.

For young athletes, it is always important to remember that they are still developing and their skeletal system has not fully matured. Typically, growth plates close by the age of 16 in girls and 18 in boys. This makes it difficult to diagnose an ankle sprain versus a growth plate fracture in younger athletes. They are sometimes treated the same way in younger athletes with the athlete being casted to protect the growth plate. So it’s a good idea to see a physician with any ankle injury in a young athlete.

Once an ankle sprain is diagnosed, there are some other important things to know. The chance of re-injury after an ankle sprain can be as high as 80 percent. Re-injury can be greatly reduced by rehabilitating an ankle sprain with a physical therapist. The treatment seeks to restore range of motion and strength, as well as restore proprioception at the ankle. Proprioception is the body’s sense of position and the changes necessary to maintain that position.

So what are some good things to work on with a therapist while in recovery?

• R.I.C.E.: This stands for Rest, Ice, Compression, and Elevation. Giving an ankle a break after the injury will help with pain levels. Icing will help reduce swelling and will decrease pain. Compression also helps reduce swelling by limiting the available space, just be sure not to make the compression so tight that good circulation is lost. Elevating the foot above the level of the heart will also help reduce swelling. All of these actions help to reduce swelling and improve range of motion.

• Range of Motion: Point the foot as far down as possible and then bring it back up “toes to nose.” Also move the foot side to side. Both should be done in a pain-free range as often as possible.

• Proprioception training: As soon as possible, try balancing on one foot. When that becomes too easy, try balancing on one foot while brushing teeth. This helps reinforce the brain’s ability to perceive ankle position and make necessary corrections.

Taking these actions will help a young athlete in his or her recovery from an ankle sprain and keep them a step ahead.