{"id":1448,"date":"2025-05-26T10:40:42","date_gmt":"2025-05-26T10:40:42","guid":{"rendered":"https:\/\/osteosalvador.pt\/?p=1448"},"modified":"2025-05-26T09:47:03","modified_gmt":"2025-05-26T09:47:03","slug":"ankle-sprain","status":"publish","type":"post","link":"https:\/\/osteosalvador.pt\/en\/entorse-do-tornozelo\/","title":{"rendered":"Ankle Sprain: Symptoms, Treatment (What to do in the first 24 hours) and How to Prevent Recurrences"},"content":{"rendered":"<p class=\"\" data-start=\"282\" data-end=\"475\">To <strong data-start=\"284\" data-end=\"308\">ankle sprain<\/strong>also known as <strong data-start=\"332\" data-end=\"357\">tibio-tarsal sprain<\/strong>is one of the most common musculoskeletal injuries, affecting people of all ages and levels of physical activity.<\/p>\n<h2 class=\"\" data-start=\"477\" data-end=\"493\">Epidemiology<\/h2>\n<p class=\"\" data-start=\"495\" data-end=\"924\">Ankle sprains are among the most common injuries in sports. Prospective studies indicate a cumulative incidence rate of 11.5 per 1000 exposures and a prevalence of 11.8%. The most common form is sprain with inversion and internal rotation of the foot, often with associated plantar flexion. The anterior peroneal-astragalus ligament (APAL) is the most frequently injured in these cases.<\/p>\n<p class=\"\" data-start=\"926\" data-end=\"1070\">In the most serious cases of <strong data-start=\"951\" data-end=\"975\">ankle sprain<\/strong>Other ligaments, such as the peroneus calcaneus or deltoid, may also be compromised.<\/p>\n<p class=\"\" data-start=\"1072\" data-end=\"1348\">The average time to return to sport after an ankle sprain varies between 16 and 24 days. However, many athletes experience recurrences or chronic problems. Recurrence rates are high, especially in sports such as basketball, volleyball and American football.<\/p>\n<p class=\"\" data-start=\"1350\" data-end=\"1631\">An ankle sprain can develop into chronic instability, with a feeling of joint failure, persistent pain and functional limitation. Around 40% of people with repeated sprains develop this condition, with a negative impact on quality of life and physical activity.<\/p>\n<h2 class=\"\" data-start=\"1633\" data-end=\"1652\">Risk Factors<\/h2>\n<p class=\"\" data-start=\"1654\" data-end=\"1729\">The main factors that increase the risk of ankle sprain include:<\/p>\n<ul data-start=\"1731\" data-end=\"1986\">\n<li class=\"\" data-start=\"1731\" data-end=\"1762\">\n<p class=\"\" data-start=\"1733\" data-end=\"1762\">Previous history of sprains;<\/p>\n<\/li>\n<li class=\"\" data-start=\"1763\" data-end=\"1816\">\n<p class=\"\" data-start=\"1765\" data-end=\"1816\">Muscular weakness of the ankle stabilisers;<\/p>\n<\/li>\n<li class=\"\" data-start=\"1817\" data-end=\"1859\">\n<p class=\"\" data-start=\"1819\" data-end=\"1859\">Changes in balance and proprioception;<\/p>\n<\/li>\n<li class=\"\" data-start=\"1860\" data-end=\"1897\">\n<p class=\"\" data-start=\"1862\" data-end=\"1897\">Congenital ligament instability;<\/p>\n<\/li>\n<li class=\"\" data-start=\"1898\" data-end=\"1941\">\n<p class=\"\" data-start=\"1900\" data-end=\"1941\">Slippery or uneven surfaces;<\/p>\n<\/li>\n<li class=\"\" data-start=\"1942\" data-end=\"1986\">\n<p class=\"\" data-start=\"1944\" data-end=\"1986\">Muscle fatigue, especially in athletes.<\/p>\n<\/li>\n<\/ul>\n<h2 class=\"\" data-start=\"1988\" data-end=\"2043\">Differential Diagnosis in Physiotherapy and Osteopathy<\/h2>\n<p class=\"\" data-start=\"2045\" data-end=\"2283\">It is important to differentiate <strong data-start=\"2072\" data-end=\"2097\">tibio-tarsal sprain<\/strong> of other injuries that involve pain in the area, such as fractures or osteochondral lesions. Tests such as the anterior drawer and talar tilt help to identify specific ligament injuries.<\/p>\n<h2 class=\"\" data-start=\"2285\" data-end=\"2306\">Injury Mechanism<\/h2>\n<p class=\"\" data-start=\"2308\" data-end=\"2506\">Most ankle sprains occur due to a forced inversion and plantar flexion movement. In less common situations, eversion movements (foot outwards) can injure the deltoid ligament.<\/p>\n<h2 class=\"\" data-start=\"2508\" data-end=\"2533\">Classification by Grade<\/h2>\n<p class=\"\" data-start=\"2535\" data-end=\"2592\">Ankle sprains are classified into three degrees:<\/p>\n<ul data-start=\"2594\" data-end=\"2849\">\n<li class=\"\" data-start=\"2594\" data-end=\"2679\">\n<p class=\"\" data-start=\"2596\" data-end=\"2679\"><strong data-start=\"2596\" data-end=\"2617\">Grade I (light):<\/strong> Mild ligament strain, moderate pain, no instability;<\/p>\n<\/li>\n<li class=\"\" data-start=\"2680\" data-end=\"2764\">\n<p class=\"\" data-start=\"2682\" data-end=\"2764\"><strong data-start=\"2682\" data-end=\"2705\">Grade II (moderate):<\/strong> Partial rupture, oedema, intense pain and some instability;<\/p>\n<\/li>\n<li class=\"\" data-start=\"2765\" data-end=\"2849\">\n<p class=\"\" data-start=\"2767\" data-end=\"2849\"><strong data-start=\"2767\" data-end=\"2788\">Grade III (severe):<\/strong> Total rupture, marked instability and functional limitation.<\/p>\n<\/li>\n<\/ul>\n<h2 class=\"\" data-start=\"2851\" data-end=\"2905\">Week One: PEACE &amp; LOVE Therapeutic Approach<\/h2>\n<p class=\"\" data-start=\"2907\" data-end=\"2986\">In the acute phase (first 5-7 days) with special attention to the first 24 hours, the approach <strong data-start=\"2955\" data-end=\"2971\">PEACE &amp; LOVE<\/strong> is recommended:<\/p>\n<h3 class=\"\" data-start=\"2988\" data-end=\"2997\">PEACE<\/h3>\n<ul data-start=\"2998\" data-end=\"3278\">\n<li class=\"\" data-start=\"2998\" data-end=\"3043\">\n<p class=\"\" data-start=\"3000\" data-end=\"3043\"><strong data-start=\"3000\" data-end=\"3013\">Protection:<\/strong> avoid aggravating movements;<\/p>\n<\/li>\n<li class=\"\" data-start=\"3044\" data-end=\"3076\">\n<p class=\"\" data-start=\"3046\" data-end=\"3076\"><strong data-start=\"3046\" data-end=\"3059\">Elevation:<\/strong> reduce oedema;<\/p>\n<\/li>\n<li class=\"\" data-start=\"3077\" data-end=\"3146\">\n<p class=\"\" data-start=\"3079\" data-end=\"3146\"><strong data-start=\"3079\" data-end=\"3109\">Avoid anti-inflammatory drugs:<\/strong> so as not to interfere with healing;<\/p>\n<\/li>\n<li class=\"\" data-start=\"3147\" data-end=\"3185\">\n<p class=\"\" data-start=\"3149\" data-end=\"3185\"><strong data-start=\"3149\" data-end=\"3164\">Compression:<\/strong> control swelling;<\/p>\n<\/li>\n<li class=\"\" data-start=\"3186\" data-end=\"3278\">\n<p class=\"\" data-start=\"3188\" data-end=\"3278\"><strong data-start=\"3188\" data-end=\"3201\">Education:<\/strong> inform the patient about the recovery process from the ankle sprain.<\/p>\n<\/li>\n<\/ul>\n<h3 class=\"\" data-start=\"3280\" data-end=\"3288\">LOVE<\/h3>\n<ul data-start=\"3289\" data-end=\"3518\">\n<li class=\"\" data-start=\"3289\" data-end=\"3342\">\n<p class=\"\" data-start=\"3291\" data-end=\"3342\"><strong data-start=\"3291\" data-end=\"3301\">Charge:<\/strong> gradual introduction of pain-free movement;<\/p>\n<\/li>\n<li class=\"\" data-start=\"3343\" data-end=\"3394\">\n<p class=\"\" data-start=\"3345\" data-end=\"3394\"><strong data-start=\"3345\" data-end=\"3358\">Optimism:<\/strong> encourage a positive mindset;<\/p>\n<\/li>\n<li class=\"\" data-start=\"3395\" data-end=\"3458\">\n<p class=\"\" data-start=\"3397\" data-end=\"3458\"><strong data-start=\"3397\" data-end=\"3416\">Vascularisation:<\/strong> maintain circulation with light activities;<\/p>\n<\/li>\n<li class=\"\" data-start=\"3459\" data-end=\"3518\">\n<p class=\"\" data-start=\"3461\" data-end=\"3518\"><strong data-start=\"3461\" data-end=\"3475\">Exercise:<\/strong> mobility and progressive muscle strengthening.<\/p>\n<\/li>\n<\/ul>\n<h2 class=\"\" data-start=\"3520\" data-end=\"3564\">Physiotherapy and Osteopathy Interventions<\/h2>\n<p class=\"\" data-start=\"3566\" data-end=\"3833\">Physiotherapy and osteopathy should start early after the <strong data-start=\"3630\" data-end=\"3654\">ankle sprain<\/strong>osteopathy, with techniques such as gentle mobilisation, lymphatic drainage and myofascial release. Osteopathy is effective in correcting altered biomechanical patterns and improving circulation.<\/p>\n<h2 class=\"\" data-start=\"3835\" data-end=\"3862\">Post-sprain rehabilitation<\/h2>\n<ul data-start=\"3864\" data-end=\"4100\">\n<li class=\"\" data-start=\"3864\" data-end=\"3953\">\n<p class=\"\" data-start=\"3866\" data-end=\"3953\"><strong data-start=\"3866\" data-end=\"3898\">Subacute phase (2-4 weeks):<\/strong> mobilisations, initial proprioception and muscle strengthening;<\/p>\n<\/li>\n<li class=\"\" data-start=\"3954\" data-end=\"4100\">\n<p class=\"\" data-start=\"3956\" data-end=\"4100\"><strong data-start=\"3956\" data-end=\"3989\">Functional phase (4-8 weeks):<\/strong> advanced proprioceptive training, muscle strengthening and reintegration into sport with specific exercises.<\/p>\n<\/li>\n<\/ul>\n<p class=\"\" data-start=\"4102\" data-end=\"4237\">Osteopathy can complement rehabilitation with joint and neuromuscular techniques applied to the ankle, knee, hip and spine.<\/p>\n<h2 class=\"\" data-start=\"4239\" data-end=\"4261\">Return to Sport<\/h2>\n<p class=\"\" data-start=\"4263\" data-end=\"4450\">Returning to sport after a <strong data-start=\"4295\" data-end=\"4319\">ankle sprain<\/strong> should be gradual, respecting the body's signals. The use of kinesiotape can help prevent relapses and improve stability.<\/p>\n<h2 class=\"\" data-start=\"4452\" data-end=\"4493\">Chronic Tibio-Tarsal Instability<\/h2>\n<p class=\"\" data-start=\"4495\" data-end=\"4754\">When there is residual ligament laxity and proprioceptive deficits, chronic ankle instability can set in, resulting in recurrent sprains. The approach involves strengthening the stabilising muscles, improving balance and motor control.<\/p>\n<h3 class=\"\" data-start=\"4756\" data-end=\"4778\">Causes and Evaluation<\/h3>\n<ul data-start=\"4780\" data-end=\"4882\">\n<li class=\"\" data-start=\"4780\" data-end=\"4829\">\n<p class=\"\" data-start=\"4782\" data-end=\"4829\"><strong data-start=\"4782\" data-end=\"4809\">Mechanical instability:<\/strong> ligament laxity;<\/p>\n<\/li>\n<li class=\"\" data-start=\"4830\" data-end=\"4882\">\n<p class=\"\" data-start=\"4832\" data-end=\"4882\"><strong data-start=\"4832\" data-end=\"4860\">Functional instability:<\/strong> neuromuscular deficit.<\/p>\n<\/li>\n<\/ul>\n<p class=\"\" data-start=\"4884\" data-end=\"5040\">Clinical assessment is essential, using physical tests and tools such as the <strong data-start=\"4964\" data-end=\"4972\">CAIT<\/strong> and <strong data-start=\"4977\" data-end=\"4985\">FAAM<\/strong> to identify the functional impact of instability.<\/p>\n<h2 class=\"\" data-start=\"5042\" data-end=\"5067\">Treatment and Prevention<\/h2>\n<ul data-start=\"5069\" data-end=\"5360\">\n<li class=\"\" data-start=\"5069\" data-end=\"5156\">\n<p class=\"\" data-start=\"5071\" data-end=\"5156\"><strong data-start=\"5071\" data-end=\"5098\">Functional rehabilitation:<\/strong> strength, balance and neuromuscular control exercises;<\/p>\n<\/li>\n<li class=\"\" data-start=\"5157\" data-end=\"5255\">\n<p class=\"\" data-start=\"5159\" data-end=\"5255\"><strong data-start=\"5159\" data-end=\"5185\">Surgical intervention:<\/strong> reserved for severe cases or those not responding to conservative treatment;<\/p>\n<\/li>\n<li class=\"\" data-start=\"5256\" data-end=\"5360\">\n<p class=\"\" data-start=\"5258\" data-end=\"5360\"><strong data-start=\"5258\" data-end=\"5272\">Prevention:<\/strong> specific training programmes and the use of external supports during risky activities.<\/p>\n<\/li>\n<\/ul>\n<h2 class=\"\" data-start=\"5362\" data-end=\"5376\">Prognosis<\/h2>\n<p class=\"\" data-start=\"5378\" data-end=\"5628\">With a proper rehabilitation plan and ongoing monitoring, most people are able to fully recover from a <a href=\"https:\/\/www.hospitaldaluz.pt\/pt\/saude-e-bem-estar\/torcer-um-pe-que-fazer\" target=\"_blank\" rel=\"noopener\"><strong data-start=\"5502\" data-end=\"5526\">ankle sprain<\/strong><\/a>This significantly reduces the risk of new injuries and improves the overall function of the foot and ankle.<\/p>\n<p data-start=\"5378\" data-end=\"5628\"><a href=\"https:\/\/osteosalvador.pt\/en\/sports-injury-and-the-importance-of-physiotherapy\/\">Physiotherapy has a major impact on recovery from sports injuries<\/a>, the <a href=\"https:\/\/osteosalvador.pt\/en\/anterior-cruciate-ligament-physiotherapy\/\">recoveries from cruciate ligament ruptures<\/a> are a very common example, along with foot sprains.<\/p>","protected":false},"excerpt":{"rendered":"<p>Ankle sprains, also known as tibio-tarsal sprains, are one of the most common musculoskeletal injuries, affecting people of all ages and levels of physical activity. Epidemiology Ankle sprains are among the most common sports injuries. Prospective studies indicate a cumulative incidence rate of 11.5 per 1000 exposures...<\/p>","protected":false},"author":3,"featured_media":1465,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[10,9,24],"tags":[],"class_list":["post-1448","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-fisioterapia","category-osteopatia","category-reabilitacao"],"_links":{"self":[{"href":"https:\/\/osteosalvador.pt\/en\/wp-json\/wp\/v2\/posts\/1448","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/osteosalvador.pt\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/osteosalvador.pt\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/osteosalvador.pt\/en\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/osteosalvador.pt\/en\/wp-json\/wp\/v2\/comments?post=1448"}],"version-history":[{"count":2,"href":"https:\/\/osteosalvador.pt\/en\/wp-json\/wp\/v2\/posts\/1448\/revisions"}],"predecessor-version":[{"id":1466,"href":"https:\/\/osteosalvador.pt\/en\/wp-json\/wp\/v2\/posts\/1448\/revisions\/1466"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/osteosalvador.pt\/en\/wp-json\/wp\/v2\/media\/1465"}],"wp:attachment":[{"href":"https:\/\/osteosalvador.pt\/en\/wp-json\/wp\/v2\/media?parent=1448"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/osteosalvador.pt\/en\/wp-json\/wp\/v2\/categories?post=1448"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/osteosalvador.pt\/en\/wp-json\/wp\/v2\/tags?post=1448"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}