Physiotherapist guiding a leg exercise on a mat

Sports Injury Treatment in Cologne Esch

Professional physiotherapy for sports injuries at Martinusstraße 53

Call Now: 0221 - 7099885 Book Appointment

A misstep in soccer, a landing on an opponent’s foot, a hole in the turf – and the ankle gives way. Injuries like this are an everyday occurrence in recreational and club sports, in adults and teenagers alike. This page from Praxis Pirnay in Cologne-Esch explains what happens to the ligaments, when an X-ray should be taken and what the treatment of sports injuries looks like up to the return to the field.

Rolled ankle: what happens in the ankle joint and ligaments

Usually the foot tips inward over its outer edge. This puts the three ligaments at the outer ankle bone under tension. Depending on the force, they are overstretched, partially torn or torn through completely; medicine then distinguishes three grades of severity. The joint swells, and a bruise often forms. The knee is affected in a similar way: twisting movements can injure the medial collateral or cruciate ligament, and in ball sports the collateral ligaments of the fingers.

Even torn outer ligaments are generally not operated on today. A doctor often prescribes a brace (orthosis) that prevents the ankle from giving way but still allows the foot to be raised and lowered. Ligaments contain sensors that report the position of the joint to the brain. After an injury, this feedback works less well. Waiting alone is therefore not enough: if you do not rebuild mobility, strength and balance, you are more likely to roll the ankle again.

Children and teenagers have an additional particularity. Their bones have growth plates, which can withstand less than the ligaments. What looks like a stretched ligament can be an injury to the growth plate and needs to be examined by a doctor. In addition, tendon attachments are sensitive to a lot of training during growth, typically below the kneecap or at the heel.

Typical injury situations on the field and in the sports hall

Landing after a jump

When blocking in volleyball, going for a header or taking a jump throw, the foot lands at an angle or on someone else’s foot and tips over its outer edge.

Duels and changes of direction

Stopping and turning abruptly with the foot planted loads the ligaments at the ankle and knee. Contact with an opponent adds to the forces.

Fatigue

Exhausted muscles react more slowly and protect the joint less well. That is why some rolled ankles only happen towards the end of a game.

Old ligament injury

An ankle that was not retrained after the first sprain often stays unstable. A smaller trigger is then enough for the next injury.

Growth spurt

When bones grow quickly, muscles and tendons barely keep up in length and strength. Coordination and load tolerance fluctuate during this phase.

What you notice after rolling your ankle

In the first hours

• Pain in front of and below the outer ankle bone
• Rapid, tight swelling
• Putting weight on the foot is painful or feels unsteady
• Sometimes a noticeable tearing sensation at the moment of the accident

In the following days

• Bruise that sinks down toward the outer edge of the foot and the heel
• Stiff joint in the morning
• Pain when rolling the foot through a step and when walking downstairs
• Giving way again on small uneven spots

In teenagers who are still growing

• Tenderness directly on the bone instead of on the ligament
• Pain under load below the kneecap
• Heel pain after running and jumping
• Limping after training

See a doctor first: warning signs after a sports injury

Whether something is broken or torn cannot be told reliably on the sidelines. With the following signs, go first to a doctor’s office or an emergency department – children and teenagers with a swollen joint in every case.

Right after the accident and later too, you cannot take four steps.
Tenderness directly on the bone, for example at the back edge of the ankle bone or at the outer edge of the midfoot.
Visible deformity, an open wound, or a numb, cold, pale foot: call the emergency number 112.
At the knee, a pop or a sudden giving way with rapid swelling.
After a collision, headache, nausea, dizziness or a memory gap: stop playing and see a doctor the same day.
Loss of consciousness, repeated vomiting or a seizure: call the emergency number 112.

Treatment of ligament injuries in Cologne-Esch

Physiotherapy supports healing in phases: first reducing swelling and moving, then strengthening and stabilizing, and finally loading the joint in a way that resembles your sport. Which of the following therapies you receive depends on the prescription from your doctor (Heilmittelverordnung).

Physiotherapy exercises (Krankengymnastik)

You train the muscles on the outside of the lower leg that catch a rolling ankle, and you practice balance on increasingly wobbly surfaces. Later, jumps, landings and quick changes of direction are added.

Manual lymphatic drainage

When swelling is pronounced, gentle manual techniques promote the drainage of fluid from the tissue. The joint is then often easier to move. A separate prescription is required.

Manual therapy

After the time in the brace, pulling the foot upward is often limited. We mobilize the upper ankle joint with our hands – a prerequisite for smooth rolling through the step, a deep squat and stairs.

Cold and heat

In the first days, cold relieves pain and the sensation of swelling. We use heat only later, when the calf is tense after a long period of rest, and not on a freshly injured joint.

From the rolled ankle back to team training

1
Assessment
We ask how the accident happened and what the medical diagnosis is, measure swelling and mobility, and check how steadily you stand and walk.
2
Goals and stages
You tell us which sport and which level you want to return to; we explain the stages that lead there. With teenagers, we involve the parents.
3
Reducing swelling and moving
First come decongesting measures and low-pain movement exercises, as far as your doctor’s instructions on weight-bearing allow.
4
Building stability
Strength and balance training make up the largest part of the series. For home, you receive exercises that take only a few minutes.
5
Load tests
Before we finish, we compare single-leg stance, hopping and changes of direction with the healthy side. The clearance for sport is given by your doctor.

First aid and exercises for the ankle

You can manage the first minutes and days after rolling your ankle quite well yourself. If one of the warning signs mentioned applies, a medical examination takes priority.

Rest, cool, compress, elevate

Stop playing, cool with a cloth between the cold pack and your skin, apply an elastic bandage and raise the leg above heart level. The bandage must not constrict.

Wear the brace consistently

A prescribed brace protects the healing ligament from rolling again. Wear it for as long as your doctor’s office specifies, even if the foot already feels fine.

Move early

While sitting, pull your foot up and stretch it out again several times a day, as far as it hardly hurts. Leave out sideways tilting at first.

Practice balance

As soon as full weight-bearing is allowed, stand on the injured leg while brushing your teeth. Once that works reliably, close your eyes or stand on a folded towel.

Coming to Martinusstraße with a sports injury

Our rooms are at Martinusstraße 53 in 50765 Cologne, in the north of the city and close to Pesch and Auweiler. If you are limping, you can drive right up to the practice and park there; the route leads via the A57 (exit Köln-Chorweiler) or the A1 (exit Köln-Bocklemünd). From the bus stop “Esch Schulstraße” it is a few minutes on foot.

Besides your prescription and insurance card, bring the doctor’s report and any existing X-ray or MRI findings. Please also bring your brace, shorts and sports shoes, because we practice standing and walking. At the first appointment we carry out the assessment, so we plan more time for it.

You can make an appointment by phone or via the appointment form on this website. German, English and Spanish are spoken in Cologne-Esch; at the reception desk, you can also be helped in Turkish.

Opening hours: Mon 7:00–20:00, Tue 8:00–19:50, Wed 8:00–19:30, Thu 7:00–19:50, Fri 7:00–15:30

Frequently asked questions about torn ligaments and rolled ankles

Does a torn outer ligament at the ankle have to be operated on?

In most cases, no. The usual treatment is a brace and early, guided movement, followed by strength and balance training. Surgery is more likely to be considered with additional injuries or persistent instability. That decision is made by a trauma surgeon or orthopedist after the examination.

When can I play soccer again after a torn ligament?

That depends on the severity and cannot be set by the calendar. The yardstick is criteria: the swelling has gone down and the joint moves fully, and single-leg stance, hopping and changes of direction work reliably and without pain. After a mild sprain this is reached considerably sooner than after a tear.

Why does my foot keep rolling over?

Often because after the first injury people only waited. The ligament does heal, but muscle strength and the feedback about the position of the joint remain weaker. Targeted balance and strength training can lower the risk of rolling the ankle again. If the joint remains unstable despite training, it should be re-examined by a doctor.

My child has knee pain after training – is that growth?

Possibly, but a doctor should assess it. In athletic teenagers, the tendon attachment below the kneecap is often irritated, known as Osgood-Schlatter disease. Often it is enough to temporarily reduce jumping and sprinting instead of stopping completely. Limping, swelling or pain at night should be checked promptly.

Who issues the prescription for my child or me?

The treating doctor, for example from a family doctor’s, pediatrician’s or orthopedic practice. People with statutory health insurance aged 18 and over pay the statutory co-payment unless they are exempt; for children and teenagers it does not apply. Those with private health insurance clarify reimbursement with their insurer in advance.

Book Your Appointment

0221 - 7099885