Ankle Sprains: Treatment and Prevention
By Nicholas J. Avallone, M.D.
Every day thousands of people in the United States sprain their ankle while doing activities ranging from sports participation to simple household activities. Typically, patients note that their ankle twisted inward, and they felt a pop. This is often followed by difficulty walking with pain and swelling about the ankle.
The ligament most frequently injured in ankle sprains is the anterior talofibular ligament, which resides on its lateral or outside aspect. A stretching or tearing of only this ligament is often considered a mild sprain. More severe levels of injury are encountered as more ankle ligaments are involved.
After an ankle injury, one must assess the need to seek medical attention. Generally, if a patient can walk on the ankle and shows improvement over the course of the first few days, then this can be considered a mild injury. However, if the person is not able to bear weight on the ankle due to severe, unrelenting pain, then a visit to a physician for an xray is advised. If the xray is not shown to find a fracture, then it can be considered a sprain in an adult. However, if the growth plates are still open in a child, a subtle fracture can be difficult to diagnose. An orthopedic surgeon should examine this patient and will often provide a cast if a growth plate injury is found.
Treatment for an ankle sprain initially consists of the RICE regimen: Rest, Ice, Compression, and Elevation. Injured ankles tend to swell a great deal and can remain that way for many months after an injury. This is why ice and elevation are good things to do at night and after exercises, even months after the initial injury. Remember to never put ice directly on the skin as this can cause frostbite. Also, “20 minutes on: 20 minutes off” is a good rule of thumb for duration of cold treatment.
Restoring motion in the ankle is a challenge after ankle sprains. Initially, one should try moving the ankle up and down, followed a few days later by trying to move it side to side. Sprained ankles will frequently be stiff in the morning and after sitting for long periods. Moist heat is typically helpful in loosening stiff tissues. Formal physical therapy may be necessary to gain a full recovery.
Strengthening and balance training are the final steps in recovery. While sitting in a chair, use an elastic rubber tube that is tied to a table leg and the other end tied to your ankle. Move each ankle inward and outward against resistance. One can improve balance through practice standing on one foot. Have a stable object nearby to grab hold of in case you lose your balance.
Prevention comes in the form of continued diligence in the patient’s strengthening and balance exercises for both ankles. Taping the ankle and/or use of comfortable ankle braces are good modalities for those susceptible to ankle sprains.
For more information regarding the ankle joint and other orthopedic topics please contact Orthopedic Associates of the Greater Lehigh Valley at 908-859-5585 or visit www.bonedrs.com.
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