What to expect when you sprain your ankle.
Ankle sprains are the most common injury in cheerleading. A 2022 article in the Orthopedic Journal of Sports Medicine, by Amy Lu, BS et al noted that ankle sprains make up 22–45% of cheer injuries. Like all athletes, cheerleaders naturally want to recover from an injury as quickly as possible and to return to the sport we love. As one of the biggest predictor of a new injury is a prior injury, it’s important to fully recover from an ankle sprain before fully returning. In this article you’ll learn more about the anatomy of a sprain, what it takes to recover from a sprain and when you can return to sport.
Ankle sprains in cheerleading may happen when landing ‘wrong’ out of a tumbling pass or jump, when stepping on the edge of a mat or when twisting and stepping awkwardly in a stunt.
A ligament is what attaches one bone to another. It provides feedback to your brain for where your body is in space. An sprain is an overstretched or tear to a ligament. in the medical field we grade these injuries by degree. A grade one is mild, a grade 3 is worse.
For the ankle the most common type of ankle sprain is an inversion sprain. This happens when the ankle rolls to the outside. This will put stress on the lateral ligaments. These attach the tibia and calcaneus to the fibula and are the posterior talofibular, anterior talofibular, and calcaneal fibular ligaments.
When the ankle rolls in, it is an eversion sprain. This puts strain on the medial ligaments which are called the deltoid ligament and attach the tibia and talus
When you sprain a ligament you may have pain in the area of the sprain. A mild grade 1 sprain may be more sore and tender. A grade 3 will likely cause more pain and difficulty walking. You will likely have swelling which is the bodies way of protecting the joint. Swelling provides stability and brings in healing properties to the joint, but it also inhibits muscular control and mobility of the joint. The first goal of recovering from an ankle sprain is to regain range of motion and decrease the swelling.
While ligaments will heal, they do not regain their same stability when they are torn. Therefore it’s important to build strength around the area to promote stability and prevent further injury.
Healing time may vary but average healing for any tissue is 6–8 weeks. Generally pain and bruising will decrease and resolve in 2–4 weeks. If there isn’t more stress to the area, swelling may also resolve. As pain and swelling are decreased, motion is returned, and strengthening can progress.
Management of an ankle sprain may involve immobilizing by use of a walking boot for a worse sprain and a lace up brace for more mild sprains, or as the ligaments heal for a worse sprain. A boot may be worn from 2–6 weeks depending on the degree of sprain. A lace up brace may be recommended when you return to participation to help protect the joint. The benefit of a brace vs tape is it allows some movement while still providing support. The long term goal should always be to improve strength and stability and eventually not need the brace.
Current research supports a “PEACE and LOVE” (protect, elevate, avoid anti-inflammatory, compress, educate, load, optimism, vascularization, exercise) approach vs just the RICE (rest, ice, compression, elevation)approach to healing. A big part of healing involves learning how your body moves, believing that you will return, and getting moving early in the process. You can read more about ‘peace and love’ in this article.
https://www.physio-pedia.com/Peace_and_Love_Principle
As you progress thru rehab of your ankle, you will move from passive work (massage, stretching)to more active work (exercises). This will include work to improve strength, flexibility, joint motion, balance, reaction time, dynamic stress such as jumping and change of direction. Building strength in the hip and core as well as the ankle is also needed to fully recover.
For cheerleaders the motions you need to do to return to practice include being able to squat at least to parallel; to stand on one leg with good hip alignment; be able to get up and down from one knee with good form; and to be able to jump and land in place. There may be mild pain as you stress the area, but the pain should not linger more than 30 minutes and the ankle should not swell to the same level as the initial sprain. More importantly, building stability and control will help you return confidently and reduce your risk for further injury.
It’s natural to want to return quickly after you have an injury but for your long term health and to reduce the risk of being out even longer with a more serious injury, take the time and do the work. Get in to see a physical therapist asap to start moving earlier. After a mild sprain you may not even need to miss time from the mat, but you can build mobility, strength and stability to get you even stronger. Take the time, do the work and get back better than before. :)
For more specific exercises that will help you recover from an ankle sprain and return to cheer, come join the Healthy Cheerleading Facebook Group.