Ankle sprain treatment

Black and blue. Ouch!

Keywords; ankle sprain treatment, chiropractic help, plantar myofascitis.

Few of us will escape the need of treatment of a lower leg injury on one or another occasion. A soft-ball slide, standing unexpectedly on the edge of the pavement or uneven ground, can and does from time to time cause awesome injuries to the ankle. Note the swelling, and the bruising from torn tissues.

It could be from a fracture within the ankle, but more likely it is due to torn ligaments or tendons.

Like all sportsmen and women, I have had my shares of sprains and strains. Of the three major events I have experienced, sprained ankle, a calf muscle strain and a slipped disk ... the ankle was by far the worst. Perhaps only by a small margin, on second thoughts. That ankle sprain troubled me for six months in my pre-chiropractic days. Ouch!

Update: I wrote this page some five years ago. My recent run in with a femoral nerve damage must surely compete with that ankle injury, only it lasted two months under chiropractic care.

Worse, it disabled me. I had to give up squash for six months. And what cured it? This is dinkum, latent heat fusion ...

Chronic foot pain - plantar myofascitis

Treatment of a sprained ankle will include careful chiropractic management of any subluxation of the talus bone in the ankle mortise joint. Other joints in the foot, leg and even pelvis too, of course. During such a sudden sprain, a chain events often shakes up the whole spine. Thereafter ankle exercises are vital to prevent reoccurence and a future plantar myofascitis ...

Whilst sprained ankle often happens in sport, or stepping unexpectedly on the edge of the curb, never forget our CHIROPRACTIC HELP safety on the stairs page. In your own home it's paramount.

CHIROPRACTIC HELP Safety on the stairs ...

On a personal note...

I was playing an important squash match when, at full stretch, I put my foot clumsily into the crack between the floor and the wall. The stab of pain as my ankle turned was one of the most painful things I have ever experienced. Sadly, I had to concede, as there was absolutely no possibility of continuing the match.

Within half an hour the ankle was very swollen and the next day there was bruising spreading down into the toes. Those were pre-chiropractic days, and I had no idea what to do.

The only suggestion of the school nurse for ankle sprain treatment was to use ice. Placing weight on the foot caused sharp stabs of pain within the ankle, and I had to use crutches for a week.

The ankle was extremely unstable, and for about six months, it would turn suddenly and unexpectedly, with sharp pain, and swell just whilst walking on level ground. After a few months the side of my knee started to ache.

It's a myth that, if you can walk on the walk on the ankle, that nothing is broken.  Fortunately mine was not broken, though it should have been x-rayed.

What occurs in a sprained ankle?

  • First and foremost the talus bone, which connects the foot to the lower leg, subluxates. This is the cause of the incredibly sharp, stabbing pain.
  • Secondly, the ankle ligaments are frequently sprained , and may very occasionally completely rupture. Fortunately this is very exceptional. This sprain is the most likely cause of the bruising frequently associated with a sprained ankle.
  • Thirdly, the muscles or a tendon may be strained.
  • Fourthly, a fracture may occur, usually the lateral malleolus or the head of the fifth metatarsal (called a Jones fracture). The ligaments and tendons are so strong that the bone fractures before the ligament or tendon ruptures. This is called an avulsion fracture . Can you spot the fractures on these x-rays? Occasionally they may need to be pinned.

TIP: Every day is a good day to quit smoking, but particularly today - avulsion fractures in smokers usually need to be pinned. The bone doesn't get enough oxygen, so after 6 weeks when the cast comes off, if it's still not healed, you have an operation and another two months in a cast to look forward to. Your call.

Can you spot the Jones fracture (below) on the side of the foot? There is a little white marker. This has to be cast, or it won't heal. The first priority in the treatment of a sprained ankle is the management of any fractures obviously. There are very few chiropractors equipped to do this, though the introduction of the post-graduate FICS programme is changing that. (see below)


An x-ray is important before chiropractic ankle sprain treatment if there is any suggestion of possible fracture, as adjusting the ankle would obviously aggravate the condition.

  1. To facillate normal quick healing, the first treatment is to adjust the subluxated talus bone. This is not usually particularly painful, and can be done with a standard chiropractic technique. Restoring the normal biomechanics enhances the normal healing time.
  2. If there is fracture, usually of the large bony bump on the side of the ankle (called the lateral malleolus) or a bone on the very side of the foot (head of the fifth metatarsal), then casting of the ankle by an orthopaedist is recommended.
  3. Sprain and strain of ligaments and tendons is done using the standard RICE ankle sprain treatment method: Rest, Ice, Compression bandage, Elevate.

Usually more than one tissue is injured and unfortunately the treatment of one (eg a fracture) may contra-indicate the treatment of another (eg ice on the sprain, or adjusting the talus). Fracture will always take precedence. The talus can always be adjusted once the fracture has healed.

Sports chiropractic is now an integral part of the profession since the establishment of Federation International Chiropractic Sports ( FICS online ), a training course for chiropractors interested in treating sportsmen and women.


Ankle sprain treatment should ALWAYS include rehabilitation. Ankle exercises plus stretches plus ankle muscle strengthening. Otherwise another sprain is just around the corner and the likelihood of a nasty chronic plantar myofascitis!

A good ankle exercise stretch is simply to kneel on a carpet, with your toes pointed out behind you. Sit back on your heels, pressing them gently down towards the carpet. You should feel the stretch in the front and sides of the lower leg (not the calf).

Another essential stretch is for the Achilles / calf muscle complex. Stand about one metre from a wall, with one foot forward,knee slightly bent, and the other straight with the heel firmly on the ground. Stretch forwards, first with the leg straight, and then slightly bent.

Strengthening weak muscles and stretching damaged ligaments so they remain flexible, mobilising the subluxated joint, and finally re-establishing what is called "proprioception" are all important parts of ankle sprain treatment. Do it! Wobble boards are important aspect of chiropractic ankle exercises ... are easily available, and really make a difference. Ask your chiropractor where you can buy one locally, or very easy to turn on a lathe if your are at all handy. 

Whilst not every sprained ankle necessarily needs professional care, I am finding more and more patients complaining of foot and ankle pain, such as plantar myofascitis, that has its origins in a long forgotten sprain sprain (years ago). When in doubt, treatment of a sprained ankle should include a chiropractic examination. If a subluxated Talus bone or a subtalar joint dysfunction, for example, is not corrected, it will alter your gait and inevitably leads to changes in the foot.

This is particularly true if you are a sportsman and woman - footflare occurs and your performance will drop off. Plantar myofascitis often has its origin in a long forgotten injury that really should have had ankle sprain treatment.

An aside: A report in a geriatric medicine research journal reveals that older persons who do balance exercises every day (such as a wobble board, though just standing on one foot makes a good start) are much less likely to fall and break a hip or crack their head on the floor, the most common cause of death. When you're done with your wobble board, give it to mum for a birthday present. She will bless you in time. Tell her to be careful, or she may be needing ankle sprain treatment!

For more interesting cases from the Chiropractic Coalface, click here: CHIROPRACTIC COALFACE ...


Severe disabling arthritis of the ankle is less common than in the knee and hip, however it remains a regular challenge in every chiropractic clinic periodically. Invariably, it's an old sprain or fracture that was not well managed with the proper ankle sprain treatment; the hyaline cartilage degeneration is often accompanied by obesity, perhaps in part the cause, often the result of the disabling arthritis from the original injury.

If you can't walk regularly because your ankle hurts, you're likely to put on weight, further aggravating the problem. Worse, how fast you can and do walk, research proves, will directly affect your longevity.

Joint distraction is one excellent option for advanced arthritis in the knee or ankle.

Useful links

Choosing the right shoes is vital if you plan to walk or jog safely after your Chiropractic Ankle Sprain treatment. A firm strap around the heel helps to prevent pronation, and a solid rubber heel reduces shock to the cushioning under the foot. If you have a tendency towards flat feet, make sure there is good arch support to prevent pronation.

At this site you will get some straight forward advice in what is really quite a difficult topic. Ankle sprain treatment begins with the best walking shoes ...

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What Other Visitors Have Said

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Interesting challenges of the day

1. Mrs B has had one of the nastiest of conditions; vertigo caused by a disturbance in the inner ear. Falling repeatedly and vomiting she consulted her doctor but medication didn't help. After two sessions of the Epley manoeuvres she was 50 percent better. After two weeks she was 75 percent improved; no longer vomiting or falling. She's not enjoying the Brandt Daroff home exercises.

2. Mr S, a 48 year old man, has right low back pain, groin pain and a numb feeling in his lower leg when he sports. For six months he's been off football. He too has two problems; a very treatable lumbar facet syndrome and a very serious blocked artery in the groin; it's called intermittent claudication. Smokers beware.  

3. Mr S looks like the leaning tower of Pisa; he has a slipped disc at L5 making him lean towards the opposite side. It's called the postero lateral disc hernia; we'll fix it, but he has to stop for a week or two. Antalgias are serious so take them seriously. 

4. Mrs V too has two conditions; a chronic low grade sciatica giving her an ache in the right leg, and a threatening Morton's neuroma. She's glad I'm back in Holland; chiropractic fixed it before, and we'll fix it again. 

5. Mrs W is one of the lucky ones, says her doctor. I agree. He says only 40% of patients with lumbar stenosis have a successful operation. We fixed a nasty slipped disc three years ago, but it came back two years later; the surgeon did a fine job but she has a weak ankle now giving her subtalar joint pain; it's routine stuff. 

6. I myself had an acute exacerbation of a femoral nerve lesion last year. One immediate treatment of the new strain by my colleague has fixed the pain in the lower back, but there's some residual numbness in the lower leg; no soaring tomorrow alas.

7. This lady is a 86 year old woman with a 63 scoliosis. Chronic lower back has been her lot in life but she's well pleased with chiropractic and comes for chiropractic help once a month; some conditions you can never cure.

8. She is an 78 year old woman, is doing remarkably well with a bad sciatica. But over 200 pounds she is not losing weight; in fact, gaining despite my suggestions. She's high risk for a stroke. I have referred her to a dietician to crack the whip.

9. A 61 year old man with upper cervical pain yesterday; it's not severe but also not getting better of its own accord. He's afraid it may turn very acute as when I treated him three years ago. Since then it's been fine. 

10. A 64 year old woman has had scheuermanns disease; it's left her with a spinal kyphosis and chronic middorsal pain. She responds well to chiropractic treatment provides she come every six weeks or so for maintenance treatment.

11. Mrs C has been having severe headaches, and taking a lot of analgesics. It's a non complicated upper cervical facet syndrome, and she's doing well.

12. Mrs D, a middle aged woman with hip pain of one year duration, despite other treatment. Xrays reveal an impingement syndrome and early hip arthritis. There's much to be done.

13. Mr D, a 71 year old man, has a severe ache in the shoulder and midback since working above his head. Trapped nerve tests are negative but he has advanced degenerative joints of Luschka; after just two treatments he is 50 percent better. Can we reach 90?

And so the day goes; chiropractors shouldn't be treating the elderly most medical sites state but that's so much bunkum.

Have a problem that's not getting better? Looking for a different slant on your pain? Want to pose a question?

Interesting questions from visitors

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Greetings, Dr B.
You helped me quite some time back with a soothing and professional response which turned out to be exactly correct. I now consult a local chiropractor. You write a superb newsletter, too.

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You visited this chiropractic help site no doubt because you have a problem that is not resolving and want to know more about what chiropractors do.

The quickest and most interesting way is to read one of my ebooks of anecdotes. Described by a reader as gems, both funny and healthful, from the life and work of a chiropractor, you'll love them. Priced right at $2.99, though Kindle fiddles the price without telling me.