Ankle sprain treatment

Ankle sprain treatment should be from a sports chiropractor with a FICS qualification; that's an in depth post graduate diploma for those wanting to care for track and field athletes, swimmers and so on.

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.

This page was last updated by Dr Barrie Lewis on 30th April, 2020.

Black and blue; ouch.

Sprained ankle treatment.

Ankle sprain treatment

Ankle sprain treatment is something most of us will have need of sometime; management of choice must include the examination of the mortise and subtalar joints.

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, namely a sprained subtalar joint, 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, that ankle disabled me. I had to give up squash for six months. And what cured it? This is dinkum, latent heat fusion.

Plantar myofascitis

Chronic foot pain.

Ankle sprain treatment will include careful chiropractic management of any subluxation of the talus bone in the ankle mortise joint; and 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 reoccurrence 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 is paramount.

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 shocking 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 joint, 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 fractured, though in retrospect 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.

An x-ray of a lateral malleolus fracture within the ankle.

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 example of a jones fracture.


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

  1. To facilitate normal quick recovery, 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.


Plantar myofascitis

Ankle sprain treatment should ALWAYS include rehabilitation; exercises plus stretches and muscle strengthening techniques. Otherwise another injury 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 but 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. Lean forwards, first with the leg straight, and then slightly bent at the knee.

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 an important aspect of chiropractic ankle exercises; they are easily available, and really make a difference. Ask your chiropractor where you can buy one locally, or they are very easy to turn on a lathe if you are at all handy and have some machine tools.

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 that happened years ago. Just read all the letters from correspondents at the bottom of this page.

When in doubt, treatment of a sprained ankle should include a chiropractic examination. If a subluxated mortise 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.

A wobble board.

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 injury that was not well managed with the proper ankle sprain treatment; the hyaline cartilage degeneration is often accompanied by obesity as walking and jogging become difficult; perhaps it is part the cause, but 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.

The ankle mortise joint.

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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