Episode 11 - How does it feel when us therapists get injured?
August 9th 2018 | Physiotherapy
I’m going to be talking through my own experience of spraining my ankle and returning to sport and the challenges that come along with that.
In March I sprained my ankle playing netball, I jumped up for a rebound and as I came back down my foot landed on top of someone else’s foot and my ankle rolled outwards.
I knew as soon as it happened that it was a bad sprain, it was very painful and my ankle started to swell up immediately. I was able to weight bear on it but it was very uncomfortable. I spent the night on the ferry back to Shetland and made sure to keep it moving and kept icing it every couple of hours.
My main concern when I went over my ankle was that I had two weeks until the Senior Inter county netball match against Orkney and I really wanted to be able to play. I had trained so hard over the winter months in preparation for the game and this was really bad timing.
One of the main challenges I faced was the battle between the physio in me and the athlete in me. The physio in me knew that two weeks was probably being very optimistic considering the amount of damage I’d done to the ligaments but the athlete in me wanted to make sure that I gave it everything I could to try and rehab it so that I could say that I’d given it my best shot to try to be on the court that day.
So with that said, I began a two week intense rehabilitation programme to try get my ankle in the best possible shape it could be. One of the main things I made sure I did was to keep my ankle moving, I think this is something that people tend not to do enough of in the early stages.
You may have heard of the P.R.I.C.E guidelines (Protection, Rest, Ice, Compression, Elevation) for soft tissue injuries but there has been recent evidence to promote the use of P.O.L.I.C.E (Protection, Optimal Loading, Ice, Compression and Elevation). The risk with the PRICE guidelines is that people may spend too long resting their injury. A little rest is necessary in the initial stages but a long period of immobilization can lead to decreased mobility and strength in the tissues. This can result in a delayed return to sport or normal function.
Research has shown that early mobilisation (loading) of the tissues helps to stimulate healing and allows the fibres to rebuild in the right direction rather than having a build up of scar tissue. In the initial stages it was quite sore to move and stretch my ankle but I knew that I needed to try and keep it moving so that I could give it the best possible chance.
My rehab programme included stretching, balance exercises, gentle strengthening exercises and cardiovascular work on the spinning bike. I even went for a walk in the sea to get the benefits of gentle mobilisation (optimal loading) and icing it (although this is not for the faint hearted!!). I also had regular physiotherapy and osteopathy appointments to help loosen off the tight muscles in my foot and ankle, mobilise the joints and help reduce some of the swelling.
Unfortunately, two weeks was not enough time for my ankle to fully recover despite my best efforts. Even with it taped up and with an ankle support on my ankle still wasn’t able to cope with higher impact activities like running, hopping or jumping, all of which are needed in netball.
I was gutted not to be able to play and I’ll admit that I felt quite deflated. I went on holiday the week after and admittedly didn’t do as many of the stretches as I should have done and it made me realise how fast my ankle could stiffen up! I think the walking, swimming and hiking I did while on holiday did help to keep it moving but I admittedly could have done a little bit more with it.
Once I got back from holiday I got back into the gym and started challenging my ankle more. Six weeks after injuring it I was able to get back to running but started building this up gradually. I was also able to do more plyometric work, more challenging balance exercises and really work on strengthening up my ankle. I went for some hill walks in Shetland with the nice weather and the uneven ground helped to strengthen up my ankle as well.
10 weeks after injuring my ankle I was back to playing netball again. I was really quite anxious to play but I taped it up and wore an ankle support for my piece of mind and I managed to play a whole match.
I am now four months post injuring my ankle, I did my first Park run a last month and I’ve now signed up to do a half marathon at the end of September. There a definitely a few things I have learned along the way.
- Keeping my ankle moving and stretching it in the first few weeks was really important – I realised how quick my ankle could stiffen up while I was away on holiday and I would have dreaded to think how much stiffer it could have been if I hadn’t done that intense two weeks of rehab in the initial stages
- It takes time – I was frustrated that I wasn’t able to play in the Senior Intercounty match but realistically it takes around 4-6 weeks to build back up enough flexibility, strength and balance in the ankle to be able to return to sport. I knew this leading up to the match but I had to try and give it my best shot. Even at six weeks when I started running again I had to take it gradually and not do too much at a time.
The rehab doesn’t stop just because I’ve returned to sport. It could be easy to think that since I’ve been back to playing netball and I’m back running again that I could just stop working on my ankle but the reality is that my ankle is still a bit stiff and there is certainly some more strengthening and balance work I can do with it. I’m in the gym roughly three times a week doing exercises for my ankle and I’m trying to keep stretching my ankle as much as I can. It’s a long process but I know that if I want to keep enjoying playing sports I’m going to have to keep working on it.
The good news is that injuries like this do get better. With early diagnosis and rehabilitation, you can give your ankle the best possible chance of speedy return to sport. Some people make it back to sport more quickly than I did but I am confident that the work I did will help to prevent a similar injury in the future. Let me know if you have any questions about your ankle injury and remember that the best time to fix it is as soon as possible after it happened.