Imagine this… your dancer is going across the floor and when landing a big jump, rolls their ankle. They hear and feel a pop and now it hurts to move the ankle and they need assistance walking.
All of a sudden you have a lot of questions to answer as a parent…
What is injured? How serious is it? What do we do about it?
Ankle sprains are the most common injury for dancers, and unfortunately, are often written off as “not a big deal” because they are so common. While it’s true sprains can vary in severity and each dancer will heal differently based on a variety of factors, every ankle sprain should warrant an evaluation by a healthcare professional.
Why?
To make sure it is in fact an ankle sprain and not a fracture – these injuries are not managed the same
To determine what type of ankle protection is necessary to prevent further damage – this may include crutches, bracing, taping, a walking boot, etc.
For education on ways to optimize healing through nutrition, hydration, activity modification, swelling management, sleep, etc.
To guide a safe return to dance by preparing the body for the demands of dance but without overloading the tissues – it is important to work with a dance physical therapist here
To address factors that predisposed your dancer to the ankle sprain in the first place – this decreases the risk of future injury
When is the Best Time to Seek Treatment if My Dancer Sprains Their Ankle?
Early intervention is critical for optimizing healing and preventing long-term issues like chronic ankle instability. Ideally, your dancer is evaluated and treated by a physical therapist within 48-72 hours. Based on the evaluation, the physical therapist will make recommendations for frequency and duration of treatment moving forward.
If a fracture is suspected or if you’re unsure, I recommend being evaluated by an orthopedist or sports medicine or physical medicine & rehab physician as soon as possible. Most metro and suburban areas have orthopedic urgent care clinics available, but if those are not an option for you, be sure to call a non-orthopedic urgent care clinic before arriving to ask if the clinic has an x-ray machine onsite (not all do).
How Long Will My Dancer Have to Sit Out with an Ankle Sprain?
Depending on the severity of the sprain, tolerance for and compliance with physical therapy, your dancer’s pre-existing health status, and whether healing is optimized with a holistic health approach, your dancer may be unable to participate 100% (dance “full out”) anywhere from 4 weeks to several months. It’s important to note, that a return to dance should be progressive and there should be periods that your dancer can participate in some, but not all, aspects of dance. This is why it’s so important to work with a physical therapist who understands the demands of dance and can provide safe guidelines.
It’s also important to note the strong psychological component of injuries as well. The ankle sprain may be physically healed and your dancer may have been cleared to return to all aspects of dance, but they may not trust their ankle. Being cleared to participate at 100% does not always equal 100% confidence. Sometimes this can be worked through in physical therapy and sometimes help from a mental health professional is necessary.
What if we Manage the Ankle Sprain at Home and Don’t Seek Treatment?
The body is incredible in its ability to heal itself. So given enough time and rest, the pain may go away without treatment. However, ligaments take about 4-6 weeks to heal with a mild sprain (and longer for more severe sprains) so pain that has resolved in 2 weeks should not be your guide for when it’s safe to return to dance.
While the ligament will be structurally repaired within 4 weeks to 6+ months (depending on severity), the immature scar tissue continues to remodel for much longer than that. Re-injury is more common during this timeframe, especially for dancers who never received physical therapy services. Without rehab, there will also likely be some form of instability with the potential to chronically swell for many years to come. With each ankle sprain, it gets easier and easier to sustain the next sprain, particularly if the body has not been trained to quickly respond to the rolled ankle position.
Lastly, there are often secondary complications and compensations that can result from ankle sprains including:
Anterior ankle impingement
painful pinch or blocked sensation at the front of the ankle
present with demi plie, squats, descending stairs, etc.
due to the shifting of bones after ligaments are torn
Muscle gripping in the feet, hips, pelvic floor, and beyond
an attempt to provide the body the stability it’s not getting from the ankle
Chronic ankle instability
impaired muscle activation & perception of where the body is in space
intermittent swelling and pain
These issues can show up as pain in other areas of the body or as difficulty balancing on one leg during dèveloppé, wobbly ankles en pointe, falling out of turns, decreased jump height and/or loud landings, and many other performance-related issues. This can all be addressed as part of the rehab process in physical therapy.
Can We Prevent Ankle Sprains?
Sometimes ankle sprains are a complete fluke accident and are more common to happen randomly in hypermobile dancers or during a growth spurt. However, many dancers are predisposed to ankle sprains due to modifiable factors:
Fatigue – nutrition-related, overtraining, hormonal
Dehydration – affects muscle performance as well as mental focus
Lack of muscle recovery – soreness mixed with not enough rest causes muscles not to respond as quickly or efficiently
Psychological stress – creating a direct distraction or causing the nervous system to stay in a chronically heightened state
Hip and ankle muscle weakness
Balance difficulties – usually stemming from the brain-body connection through the nervous system and inner ear
Inability to get over or stay over the pointe shoe box (**does not apply in the above scenario, but a very common factor for ankle sprains)
The Bottom Line
Whether an ankle sprain is a minor setback short-term or poses more serious risks for the future depends on the severity of the sprain and how it is managed.
If your dancer is dealing with a current ankle sprain – and pretending everything is fine to get through rehearsals due to fear they’ll be replaced…
Or if they have pain, swelling, mobility, strength, or balance issues and you’re wondering if it could be related to an old ankle sprain…
This is your sign to take action. Schedule a phone consult using the button below to gain clarity and create a plan for how to address current ankle issues and prevent future ones.
Cheers to your dancer staying safe and performing their best!
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