Ankle sprains are common injuries, especially among athletes, and can sideline you for weeks. Understanding the nature of the injury and appropriate treatment is crucial for a speedy and complete recovery. This article explores the role of massage in ankle sprain recovery, guiding you on when and how to use it effectively.
Understanding Ankle Sprains
An ankle sprain involves injury to one or more ligaments in the ankle, which connect bone to bone and stabilize the joint. Sprains range from mild, involving overstretched ligaments, to severe, where ligaments tear completely. Prompt and proper care is essential to prevent chronic issues and ensure full recovery.
First Aid and Initial Management
Immediate first aid is crucial for anyone who suspects an ankle sprain. A first aid practitioner may recommend avoiding putting any weight on the ankle, as this may increase the risk of broken bones and other injuries. They may also suggest a person sit in a comfortable position, with the ankle elevated to reduce swelling. If possible, people may want to consider wearing a temporary brace or bandage to support the joint and prevent it from moving. If crutches are available, some people find that they can help with balance and mobility while allowing the ankle to rest.
It is difficult to diagnose an ankle sprain based on symptoms alone. For this reason, a person should see a doctor. Most family care physicians and doctors at urgent care clinics can quickly diagnose a sprained ankle. If the injury is very severe, they may refer the person to an orthopedist or foot and ankle surgeon.
Doctors often recommend RICE (Rest, Ice, Compression, and Elevation) in the days following the injury to reduce swelling and inflammation.
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- Rest: Resting the ankle is key for healing, and wearing a brace can help stabilize the injured area. Attempting to return to sports or other activities too quickly increases the risk of reinjury, another injury, and prolonged healing time.
- Ice: Applying an ice pack wrapped in a thin towel for 15-20 minutes every two to three hours may reduce blood flow to the injury and help ease pain and swelling. If ice does not help relieve symptoms, people may want to try other treatments instead.
- Compression: Wrapping the injured ankle with an elastic bandage can provide support and minimize swelling. The bandage should be snug, but not so tight that it digs into the skin, hurts, or causes numbness. Mild pressure that is not too uncomfortable or tight, and does not stop blood flow is ideal. Your foot should be comfortable enough to move.
- Elevation: Elevating a sprained ankle above your waist or heart as much as possible during the recovery period, particularly for the first 24 to 48 hours after the sprain, reduces the accumulation of fluid in the joint. Try sleeping with the foot and ankle propped up on pillows at a level higher than the heart. When sitting or resting, use pillows or a footrest to keep the foot and ankle elevated.
The Role of Massage Therapy
Massage therapy can be a valuable tool in ankle sprain recovery, but it's important to understand when and how to use it appropriately. In the initial stages (first 24-72 hours), the focus should be on reducing pain and swelling.
Acute Stage (First 72 Hours)
During the first 24 to 72 hours, there is nothing wrong with a massage therapist laying his or her hands on the injured ankle, depending on your circumstances. This must, however, be done with restraint. The ankle should not be rotated, moved or aggressively touched while it's still tender. Putting hands on the injured party can have benefits. In some cases, it might help calm the injured person down. Lightly touching the area might provide relief to the injured person, almost as a kind of placebo effect. The process might even give the massage therapist an idea about the extent of the injury at that moment.
- Gentle Touch: Light, fluid-flushing strokes around (not into) the hot zone can ease pain and improve circulation without aggravating tissue.
- Manual Lymphatic Drainage: Light massage and manual lymphatic drainage can help move fluid away from the injury and relieve pressure.
Sub-Acute and Chronic Stages (After 72 Hours)
After about 72 hours, it's fine to progress to a more standard type of therapeutic massage.
- Cross-Fiber Friction: After the third day, cross-friction massage may help prevent the formation of scar tissue adhesions and even speed healing. For an inversion sprain caused by a rolled ankle, the ligaments may need to be worked in two positions: plantar and dorsi flexion. During this type of massage, the practitioner palpates the ATFL (Anterior talofibular ligament), CFL (Calcaneofibular ligament) or PTFL (Posterior Talofibular ligament) and applies cross-fiber friction to them. This is done for about 20 seconds in each location and each position. In some cases, it's hard for the masseur to know exactly which ligaments are involved or how all three have been affected. Because of this, some practitioners will massage all three. There's nothing wrong with this as a technique. Some discomfort in the injured ankle might occur, but this process should never be painful. If there is any pain or discomfort the treatment should end right away.
- Deep Tissue Massage: Deep tissue massage isn’t “harder Swedish.” It’s slower, more specific pressure aimed at deeper layers of muscle and fascia to free adhesions, restore glide, and improve range of motion. It can resolve restrictions and restore normal movement patterns. It’s most useful for sub-acute and chronic issues - lingering tightness, guarded movement, scars/adhesions, and patterns caused by older injuries.
- Myofascial Release: Using bodywork techniques like myofascial release increases blood flow to both sprained wrists and ankles, helping you recover faster.
- Trigger Point Therapy: At Bodyworks DW, therapists use techniques like myofascial release, trigger point therapy, and joint mobilization.
- Calf Muscle Massage: Massaging the calf muscle can help improve the ankle’s flexibility, as well as your ability to balance on the ankle joint. Effleurage can be used at the beginning of a massage session to warm up the calf muscle and increase blood circulation. Use the palm of your hand to make long, light strokes along the length of the calf. Petrissage is when you use alternating muscles of both hands to squeeze and release in order to further warm up the muscles. Some people may describe this technique as kneading.
Home Care and Other Therapies
In addition to massage, several other home care methods can support faster recovery:
- Heat Therapy: Once the swelling goes down, applying a heat pack for 15 to 20 minutes at a time can increase blood flow to the injury, speeding healing and relaxing tight muscles. Some people find relief from alternating heat and ice packs, but only after the swelling is gone.
- Stretching: Gently stretching the ankle by moving it in all directions at least three times each day can keep muscles strong and limber and enhance blood circulation to the area. Flexing the foot forward, then backward, or rolling it clockwise then counterclockwise restores strength, and improves flexibility and range of motion.
- Walking: As the swelling subsides, walking short distances within the house can promote healing. Gradually increase the distance as the ankle heals.
- Exercise: After the swelling goes down and walking is comfortable, exercises can restore strength and balance and prevent muscle weakening.
- Physical Therapy: A physical therapist can identify weak muscles and create a customized exercise plan to promote healing and ease pain.
Precautions and Considerations
- Avoid Pain: Massage should never be painful. If there is any pain or discomfort, the treatment should end right away. If you find yourself tightening or flinching while you or someone else is massaging the area around your ankle, you might not benefit from it.
- Professional Guidance: Consult a qualified massage therapist or healthcare professional for severe injuries.
- Underlying Conditions: If you have diabetes, vascular disease, or decreased sensation, check with your doctor before applying ice or heat.
- Don't Rush Recovery: Just because the pain is gone doesn’t mean tendons and the ligaments have fully recovered. Another common mistake is jumping back into full activity too quickly.
When to See a Doctor
While many ankle sprains heal on their own, it’s crucial to know when to seek medical attention. Consult a doctor if:
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- You have severe pain.
- You cannot put any weight on the ankle.
- The swelling does not go down after a few days.
- You suspect a broken bone or torn ligaments.
- Your sprain doesn’t seem to be improving, even with some time and massage.
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