Ankle sprain without much swelling?

Nicole (not her real name), a part-time fitness instructor came to see me yesterday with a painful right ankle joint. She told me that she twisted the ankle 3 weeks earlier but did not do much for it as she did not have much swelling. She explained that despite a nagging pain she continued to do some classes after a week's rest. She soon realised that the pain was getting more unbearable that she decided to see a doctor.

I examined and found out that she had a tenderness of the antero-lateral aspect of the right ankle, a partially torn ligament (ATFL) and poor sense of balance on the right lower limb. He peroneal tendons and the medial malleolus seemed to be problem free. True enough both ankles seemed more flexible than usual.

She was advised to avoid doing running or jumping without taping. I taught her how to tape her ankle if she had to take classes. I ran through with her the isometric exercises, theraband resistance exercises and balancing exercises she should do. Since she had a grade II sprain, I advised her to do at least 8-12 weeks rehabilitation although she would feel much better within 2 weeks.