Initially, treatment in the first 48 to 72 hours consists of resting the injured area, icing 15 to 20 minutes every two to three hours, compressing with an ACE wrap, and elevating, which means positioning the leg and ankle so that the toes are above the level of patient’s nose. Those patients who cannot bear weight are better treated in a removable walking boot and crutches until they can comfortably bear weight.

The goal would be

1.Pain relief: Using IFC, Ice, heat, Ultrasound, Laser, Ankle brace, crutches.

2. Increase range of motion: Manual therapy to improve tissue flexibility and mobility in the joint.

3.Increase strength: Progressive strengthening program.

4.Increase balance, proprioception and endurance.

5. Gait training.

6.Return back to functional activities.

7. Agility training if appropriate and as needed.

Physiotherapy treatment depends on the stages of recovery and they are as below. Usually an ankle sprain takes 6 weeks up to a period of 4 months depending on the severity of the injury.

1. Maximum protection phase: Goal is to reduce pain, decrease swelling.

2. Moderate protection phase: Goal to improve mobility, improve strength, and gait training.

3. Minimal protection phase: Advance level of exercises where the goal is to improve endurance, strength, agility and back to functional level.

In acute stage the injuries, the physiotherapy starts gentle active assisted exercises. Passive stretching is also recommended within the limits of pain to improve movement and reduce pain. As the pain reduces, active exercises and muscle-strengthening exercises are started.

Electrical stimulation, ultrasound, Shockwave therapy, Laser therapy and Heat are also used to decrease the pain and inflammation. Cyriax 1978 suggest treatment by transverse friction massages for the tendon and ligamentous injury.

Acupuncture is also considered as an active treatment for reducing pain and inflammation.

Your physiotherapist may also use suction cupping, Hawk or Graston Technique for breaking the scar tissue and massage around the injured area.

K taping of the injured area is also one of the most considered methods of treating an acute injury.

Active release techniques (ART) are also helpful in treating sports injuries.

For the lower body injury the goals are to mobilize the ankle and the foot to re-educate the walking to develop running and jumping skills to limit any swelling to stimulate the patient’s response.

A most important aspect of treatment is that of continuous assessment on Fitness testing basing the progression of treatment on the findings. The treatment plan consists of isometric quadriceps exercises, progressing rapidly weight-bearing walking too quickly towards full weight-bearing with emphasis on correct gait. 

A different approach is taken towards a pain due to sensitive nervous system