Whether it happens during a Sunday league match, a five-a-side game or simply while having a kickabout, rolling an ankle is one of those football injuries that can happen in an instant.
You change direction, land awkwardly or step on another player’s foot and suddenly the ankle gives way underneath you.
For many people, the initial pain and swelling settle relatively quickly. The temptation is then to get back to football as soon as the ankle feels reasonably comfortable.
But feeling better and being ready to play football again aren’t necessarily the same thing.
At Active Health Clinics in Maidenhead, osteopath Jatinder “JT” Liddar works with people experiencing a range of musculoskeletal and sports-related problems. When it comes to ankle injuries, the aim isn’t simply to get somebody out of pain. It’s also important to understand how the injury has affected movement and to regain the strength, control and confidence needed to return to activity.
What happens when you roll or twist your ankle?
One of the most common football ankle injuries is an ankle sprain. This happens when the ankle is forced beyond its normal range and the ligaments supporting the joint are overstretched or injured.
Depending on the severity of the injury, symptoms can include:
- Pain around the ankle
- Swelling
- Bruising or discolouration
- Difficulty putting weight through the foot
- Reduced ankle movement
- A feeling of weakness or instability
Not every ankle injury is simply a minor sprain, however, which is why assessing the injury properly is important.
When JT first sees somebody who has twisted their ankle, there are several things he wants to establish.
“Firstly, is the patient able to weight bear? Is there any discolouration, and what is their range of movement like?”
These initial observations can help build a picture of the injury and determine whether osteopathic treatment and rehabilitation are appropriate or whether further medical assessment may be needed.
When should you get an ankle injury checked?
Many ankle sprains can be managed conservatively, but some injuries require further medical assessment.
An inability to put weight through the foot, significant or worsening pain or swelling, an obvious deformity, or symptoms such as numbness or changes in colour or temperature can all warrant medical attention.
From an osteopathic perspective, JT also considers whether someone’s recovery is progressing as expected.
“If the pain hasn’t improved, particularly after a few sessions, or if there appears to be a bony abnormality, significant discolouration or something limiting the ankle’s range of movement, we would consider whether further investigation is needed.”
The important point is not to assume that every ankle injury is simply a sprain.
Why do people keep spraining the same ankle?
One of the biggest frustrations with ankle injuries is that they can become recurrent.
You’ve sprained your ankle, rested it, the swelling has disappeared and eventually it doesn’t hurt anymore. You go back to football — and before long, you roll it again.
According to JT, incomplete rehabilitation can be an important part of the problem.
“People tend to sprain their ankles again after they’ve healed because the rehab hasn’t been done correctly.”
Pain settling doesn’t automatically mean the ankle has regained its previous strength, balance, movement or ability to react to the unpredictable demands of sport.
Football is a good example. You aren’t simply running forwards. You’re accelerating, stopping, changing direction, jumping, landing, turning and reacting to other players — often at speed.
Rehabilitation therefore needs to prepare the ankle for what you’re actually asking it to do.
Osteopathy for ankle injuries: why JT looks beyond the ankle
If you’ve injured your ankle, it might seem obvious that assessment and treatment should concentrate exclusively on the ankle.
JT takes a broader approach.
“Osteopathy can help by not only looking at the ankle but looking above and even below. These could all be contributing factors to what may have led to the sprain in question.”
That can mean assessing the foot and ankle as well as looking further up the lower limb towards the knee and hip.
This can be particularly relevant following an injury because people naturally change how they move when something hurts.
If the ankle isn’t moving or functioning normally, the way you walk, run, jump or change direction may also alter.
“We have to work to try and reduce this from happening again and also stop other areas, such as the knee or hip, from being at increased risk of injury.”
This is one of the areas where an osteopathic approach can be particularly useful. Rather than concentrating solely on the site of pain, JT can assess how different areas are moving and functioning together.
Treatment and rehabilitation can then be tailored to the individual, their injury and what they need to get back to doing.
When can you return to football after an ankle sprain?
There isn’t one fixed number of days or weeks that tells everyone when they are ready to return to football.
The severity of the original injury matters, but so does how well the ankle has regained its function.
For a footballer, being able to walk around without pain is very different from being ready for a match.
Rather than relying solely on whether the ankle hurts, JT likes to see whether a patient can perform movements that start to replicate the demands of football.
“Being able to pogo jump, particularly single-legged, is very important. I’d also want someone to be able to jump laterally. These are key movements we need, especially in football.”
A single-leg pogo involves repeatedly bouncing on one leg, while lateral jumping introduces the side-to-side movement that is so common during sport.
Think about what happens during a football match. You may have to land on one foot, immediately push in another direction or stabilise yourself after contact.
The ankle therefore needs more than pain-free movement. It needs strength, control, coordination and the ability to cope with rapidly changing demands.
JT’s ankle rehab tip: use a mirror
One of JT’s favourite ankle rehabilitation tips doesn’t require expensive equipment.
Try performing some of your ankle rehabilitation exercises in front of a mirror.
The reason is proprioception.
Proprioception is your body’s ability to sense its position and movement in space. It plays an important role in balance and joint control and can be affected following an ankle injury.
JT explains:
“A top tip I can give when doing ankle rehab is to do it in front of a mirror, as that helps build what we call proprioception — your body’s ability to know where it is in space.”
The mirror provides additional visual feedback, allowing you to observe what the foot, ankle, knee and rest of the leg are doing during an exercise.
“Your body can process what you’re seeing in the mirror and understand where the ankle should land or where it should be placed when doing specific movements.”
As rehabilitation progresses, exercises can become increasingly challenging and begin to replicate the movements required for football or another sport.
Don’t just wait for the pain to disappear
One of the key messages following a football ankle injury is that absence of pain isn’t necessarily the same as full recovery.
Depending on the injury and the individual, rehabilitation may need to address:
- Ankle movement and mobility
- Strength
- Balance
- Proprioception
- Single-leg control
- Jumping and landing
- Side-to-side movement
- Gradual return to running
- Football or sport-specific movements
The exact programme will depend on the person and what they are trying to return to.
Someone who wants to walk comfortably and get back to normal daily activities has different demands from somebody preparing to return to competitive football.
Ankle injury treatment and osteopathy in Maidenhead
If you’ve twisted your ankle playing football, keep experiencing recurrent ankle sprains or feel that an old ankle injury has never quite returned to normal, an assessment can help establish what’s going on.
Jatinder “JT” Liddar is an osteopath at Active Health Clinics in Maidenhead and works with patients experiencing a range of musculoskeletal problems and sports injuries.
His approach to ankle injuries doesn’t simply focus on where it hurts. An assessment may include the ankle itself alongside the foot, knee and hip, as well as looking at how the lower limb is moving and functioning.
From there, JT can determine an appropriate treatment and rehabilitation plan based on the individual and what they want to get back to doing.
The aim is not simply to get you feeling better. It’s to help restore the movement, strength and function you need for everyday life or sport — and reduce the chances of finding yourself back on the sidelines with the same problem.
Frequently Asked Questions
Can an osteopath help with a sprained ankle?
An osteopath can assess musculoskeletal ankle problems and, where appropriate, use treatment alongside rehabilitation to help restore movement and function. An initial assessment can also help determine whether the injury is appropriate for osteopathic management or whether further medical investigation may be needed.
Why does my ankle keep giving way after a sprain?
There can be several reasons. Following an ankle sprain, some people may be left with reduced strength, balance, proprioception or movement. That’s why completing appropriate rehabilitation can be important even once the original pain and swelling have settled.
How long should I wait before playing football after an ankle sprain?
There isn’t a universal timeframe. Returning to football depends on the severity of the injury and how well movement, strength, balance and sport-specific function have recovered. JT may use movements such as single-leg pogo jumping and lateral jumping as part of assessing someone’s progress towards returning to football.
Should I see an osteopath if I keep rolling the same ankle?
If you repeatedly sprain or roll the same ankle, it can be worth assessing why. JT’s osteopathic assessment can look not only at the ankle but also at the foot, knee, hip and the way you move to identify factors that could potentially be contributing to the recurring problem.
When should an ankle injury be medically assessed?
An ankle injury may require medical assessment if there is severe or worsening pain or swelling, an inability to put weight through the foot, an obvious deformity, numbness or tingling, or concerning changes in colour or temperature. If you’re unsure about the severity of an ankle injury, it’s sensible to seek appropriate medical advice.
Struggling with an ankle injury in Maidenhead?
If you’ve recently twisted or sprained your ankle, keep rolling the same ankle or are struggling to return to football or another sport, you can book an osteopathy assessment with Jatinder “JT” Liddar at Active Health Clinics in Maidenhead.
JT can assess the ankle, look at how the rest of the lower limb is functioning and develop an appropriate treatment and rehabilitation plan to help you get moving again.
