The ankle joint has multiple bones, ligaments, muscles and tendons that stabilise it; however there is a risk of rolling our ankle so the foot faces in. If this happens some ligaments become damaged and the tendons and muscles may become stretched.
Care at home
Try not to do anything that hurts. Using crutches may help to take some or all the weight off the ankle while walking. Gradually increase the amount of weight your child puts on their ankle over a week or two or until they are walking normally.
Ice can be applied, but be sure to cover it and only use for 10-15 minutes at a time every one to two hours to prevent skin damage. Icing should be continued as long as there is any pain or swelling and also after any exercise.
Using a compression stocking or by a firm sock, apply pressure to the ankle for most of the day. Pressure should be firm but comfortable and your child shouldn’t get any pins and needles, or numbness. The colour of your child’s toes should remain the same on both feet.
Keep the ankle above the heart, normally achieved by lying flat with the foot elevated on pillows or a chair. This position should be maintained whenever possible and is a good position to do gentle exercises for the first week to assist with reducing swelling.
The following exercises are a basic guideline to get started. Exercises should be followed with 20 minutes of icing. Progress through to the next stages as the ankle heals. You can get an idea of what is “normal” by comparing the injured foot to the other foot.
Pump the ankle up and down slowly going as far as pain allows. Turn the big toe in and out slowly as far as pain allows.
Repeat both exercises 30 times. Hold the up and out movement for about five seconds each making sure your child goes as far as they are able. Don’t be too worried about the down and in movement because this tends to come back naturally later on.
Frequency: Do five times a day until range of motion improves and your child can take half weight on the injured ankle.
Loop a towel over the underside of the toes while sitting with the knee bent. Pull on the towel so as to bend the ankle up towards the knee. Your child should hold as far up as they can for 30 seconds, do this three times.
While seated, your child should hold the bent leg just below the knee and draw the ankle upwards as far as they can. Hold for 10 seconds and do this 10 times.
Again, while seated and holding the bent leg just below the knee, this time turn the ankle outwards by keeping the knee still and dragging the little toe to the side. Hold for 10 seconds and repeat 10 times.
Frequency: Three times a day until your child can take full weight on the ankle.
Standing on the injured leg, keep the heel on the ground and pass the knee over the top of the toes as far as able. Hold this as a stretch for about 60 seconds and do this three times.
Then place the injured leg behind straight, keep the heel on the ground and lean forward. Hold 60 seconds, do this three times.
Practice balancing on the injured leg. Be careful doing this if your child’s balance was poor before the injury, they may need to hold on to a bench or rail. Progress their balance until they can stand on the one leg for 30 seconds and then if they want a challenge they can try with their eyes closed. Compare to the good side.
Frequency: Three times a day until balance is equal side to side.
Your child may have been referred to physiotherapy for follow-up at hospital, or your child can choose to see a private physiotherapist in your area. If problems persist, see your GP.
Queensland Children’s Hospital
501 Stanley Street, South Brisbane
t: 07 3068 1111 (general enquiries)
In an emergency, always call 000.
If it’s not an emergency but you have any concerns, contact 13 Health (13 43 2584). Qualified staff will give you advice on who to talk to and how quickly you should do it. You can phone 24 hours a day, seven days a week.
Maughan KL, Ankle sprain. Online 17.3. Retrieved February 19, 2010.