Autumn Years Winter 2023/24

plains. “What are their goals, what are the activities they are trying to get back into, is there anything else going on that caused the ankle sprain or that’s hinder ing their recovery? Once the physical therapist understands the patient, they can tailor the care plan to meet his or her specific needs.” Erler adds that the entire PT session should be devoted to you. The therapist should not be bounc ing back and forth between patients. Once someone heals, the HSS experts advise getting back to activities gradu ally and monitoring how the ankle feels. They say people should wear supportive shoes and avoid walking on uneven surfaces. Walk on the sidewalk, not on the road, because roads have bends to keep rainwater from accumulating. They also recommend doing a good warm-up before an athletic activity and wearing the appropriate footwear for a specific sport. Even after you finish physical therapy, Erler says it is important to keep it up. You should have a program to do at home several times a week to maintain the progress you have made.

Goals of physical therapy “Any time you’re unable to use your an kle to its fullest potential, I think there’s an opportunity for PT to help,” says Brad Erler, a physical therapist at HSS Para mus. “Starting rehab as soon as you can gives you the best chance for success.” It can begin at home with practices such as using an ice pack and elevating the ankle to reduce swelling, he notes. Ice should be applied on and off for about 15 minutes at a time. A cloth or light towel should be used; ice should never be placed directly on the skin. PT has several goals, says Erler. Once the swelling is down, the goal is to improve range of motion and flexibility with gentle stretching and light exer cises. The next step is to strengthen the ankle with exercises that aim to restore it to its previous function. Finally, physical therapists help patients regain stabil ity with exercises that work on both strength and balance. “A good physical therapist will take his or her time with the patient and try to understand the individual as a whole—not just the injury,” Erler ex

Lessons learned From my own experience, I learned that severe swelling from the ankle down to the foot can happen within a couple of days of injury. Extreme bruising can also occur, lasting from weeks to months. If not properly treated, an ankle sprain can have long-term effects. “It is not un common for people to develop chronic in stability, even after a mild injury in which they rest their ankle for a while and feel better,” Wang says. “They think it’s fine to go back to their previous activities, but the ligaments are not the same as they were. They are always a little bit looser, potentially leading to chronic issues such as instability.” To minimize the risk of reinjury, Drs. Conti and Wang recommend physical therapy (PT) following a sprained ankle. “If you haven’t treated an ankle sprain with PT, you haven’t fully treated an an kle sprain,” Wang says. “Ligaments have what we call proprioceptive fibers. Pro prioception is your ability to know where your foot is without looking down at the ground. When you sprain your ankle and stretch or tear the ligaments, you can damage those proprioceptive fibers. PT can be very helpful to retrain them with exercises that work on balance.”

WINTER 2023/24 I AUTUMN YEARS 21