As an avid runner here in San Antonio, I have been accustomed to my share of ankle sprains. As my ankle rolls inward all I can think about is “PLEASE DO NOT let me feel or hear a pop!!” oh and of course the obvious “PLEASE DO NOT let me fall flat on my face!!”
What are the ‘need to know’ facts about ankle sprains?
Admit it, we all lost our footing and tripped causing our ankle to twist. Ankle sprains are one of the most common complaints in those whom live an active lifestyle. However, they can also occur in any age group and lifestyle.
The most common type of ankle sprain mechanism is an inversion (foot twisting inward) ankle sprain. This is due to the anatomy of the ankle joint being stronger on the inside. This causes our ankle to roll out and our foot to roll under. During this incident, you may hear a “pop”. Don’t be alarmed, this can simply mean that you developed a tear in one of you ankle ligaments. Once you sustain an ankle sprain, they commonly come back. An analogy that I like touse is to think of our ligaments as rubber bands. Consistent stretching on a rubber band causes the rubber band to loosen over time. So, once that tight ankle ligament(s) becomes loose, that ankle sprain will happen again, and again and again and well again.
Ankle sprain symptoms vary depending on severity. Often, the ankle is tender, swollen, and discolored (bruised). The ankle can be quite painful to touch. Walking is usually hampered and may become difficult depending on the severity of the sprain. A feeling of instability may occur, especially in severe ankle sprains when ligaments are torn.
The amount of force determines the grade of the sprain. A grading system has beendeveloped and used by many health care professionals
A mild sprain is a grade 1. A moderate sprain is a grade 2. A severe strain is a grade 3.
- Grade 1 sprain: Slight stretching and some damage to the ligament
- Grade 2 sprain: Partial tearing of the ligament. If the ankle joint isexamined and moved in certain ways, abnormal looseness (laxity) of the ankle joint occurs.
- Grade 3 sprain: Complete tear of the ligament. If a stress test is performed, gross instability occurs (ankle comes out of it’s joint).
OUCH! I think I sprained my ankle?
We suggest for you to see your favorite Podiatrist at AFFAC to diagnose a sprained ankle. The reason why is because we want to ensure you did not break a bone in your foot or ankle by taking a careful examination and x-rays. A broken bone can have similar symptoms of pain and swelling.
The physical exam may be painful. The doctor may need to move your ankle in various ways to see which ligament ore tendon has been injured.
If there is a complete tear of the ligaments, the ankle may become unstable after the initial injury phase passes. If this occurs, it is possible that the injury may also cause damage to the ankle joint surface itself.
An MRI (magnetic resonance imaging) scan may be ordered depending on your symptoms to evaluate the ligaments, joint surfaces for any traumatic lesions, a small bone chip or other problem. The MRI can make sure the diagnosis is correct. The MRI may be ordered after the period of swelling and bruising resolves.
Oh Boy! my podiatrist has diagnosed me with an ankle sprain, now what?
Walking may be difficult because of the swelling and pain. If that is the case, crutches or knee scooter may become your best friend for a short duration but the swelling and pain will usually last two to three days. You may also get a removal boot to help stabilize your foot and ankle during the healing process.
Most ankle sprains need only a period of protection to heal. The healing process takes about four to six weeks. Even a complete ligament tear can heal without surgical repair if it is immobilized appropriately.
For a Grade 1 sprain, use R.I.C.E (rest, ice, compression and elevation):x weeks. Even a complete ligament tear can heal without surgical repair if it is immobilized appropriately.
- Rest: your ankle by not walking on it.
- Ice: should be immediately applied. It keeps the swelling down. It can be used for 20 to 30 minutes, three or four times a day. Combine ice with wrapping to decrease swelling, pain and dysfunction.
- Compression:bandages or ace-wraps immobilize and support the injured ankle.
- Elevate: your ankle above your heart level for 48 hours.
For a Grade 2 sprain, the RICE guidelines can also be used. Allow more time for healing to occur plus immobilization.
A Grade 3 sprain can be associated with permanent instability of you ankle. Surgery is rarely needed. A short leg cast or a cast-brace may be used for two weeks to three weeks.
Non steroidal anti-inflammatory drugs (NSAIDs) may be used to control pain and inflammation.
Physical therapy is used to help decrease pain and swelling and to prevent chronic ankle problems. Proprioception training is very important after ankle sprains (especially if chronic in nature), as poor proprioception is a major cause of repeat sprain and an unstable ankle joint.
Surgery (YES! I said the “S” word) is reserved for injuries that fail to respond to nonsurgical treatment and/or for patients who are experiencing persistent instability (i.e. grade 3 ankle sprains).
Whatever the case may be it is important not to neglect treatment of an ankle sprain as this could lead to chronic instability of your ankle joint and lead to damage to your ankle joint. Also this may cause foot, ankle or even knee pain.
At Alamo Family Foot and Ankle Care (AFFC), we offer a variety of treatment options aimed at relieving your foot and ankle ailments. If conservative treatment fails, our surgical skills and techniques are proven to work, so you can continue dancing, running or whatever your feet and ankles may take you. If you are a patient suffering from ankle sprains, please let us help you get back on your feet by calling our office.