Ankle Sprains: A Common but Treatable Injury

December 21, 2017

Few people make it all the way through life without experiencing an ankle sprain to some degree.  It is undoubtedly one of the most common injuries seen in sports medicine.  Ankle sprains are quite prevalent in basketball, football, soccer, volleyball, track and baseball.  However, anyone who participates in sporting activities involving walking or running is susceptible to an ankle sprain.


Over the years, the term “ankle sprain” has become almost slang for any injury involving the ankle.  In reality, an ankle sprain is a very specific injury.  It is defined as an acute injury to the ligaments of the ankle joint.  It is the ligaments that hold bones together.  Ankle sprains can occur on either side o the ankle.  The vast majority, about 85 percent, occurs on the outside (lateral aspect) of the ankle. 


Injuries to the lateral ankle result from the foot and ankle being turned inward (inverted) beyond what the ankle can handle.  The inside (medial aspect) of the ankle is damaged when the ankle is turned out (everted).  A classic history for a lateral ankle sprain might be “I went up for the rebound, came down with the ball, felt my ankle twist inward underneath me, and knew that my ankle was injured.”  Stepping off of a stair or ledge and twisting the ankle inward is another classic story.


If you are trying to decide if you have a sprained ankle, it is important to look at the mechanism of injury.  Ankle sprains do not come on gradually there is almost always a specific injury associated with a sprain, such as the ones described above.  In addition to the history and mechanism of injury, ankle pain, swelling, discoloration, and tenderness to touch are other signs and symptoms of an ankle sprain.  It is usually difficult to bear weight on the injured side.


Except for very mild sprains, it is advisable to see your physician if you injure your ankle.  Although the injury will usually be a common ankle sprain that will heal with patience, time, and rehabilitation.  Occasionally, there are more serious injuries that mask themselves as a common ankle sprain. It is important that your doctor rule out the possibility of a serious fracture or other problem. 


If you have a mild ankle sprain or your doctor has placed you on a rehab program, there are several things, which can speed your recovery.  First of all, the importance of ice in relieving swelling, pain, and inflammation cannot be overstated.  The ankle should be iced for 15-20 minutes three to five times each day, additionally, it should be iced following any exercise, rehabilitation, or exertion.  It is important to begin range of motion exercises as early as possible.  This will be within one to three days for a mild sprain.  If your injury is moderate or severe, your doctor should decide when it is OK for you to begin range of motion exercises.


A good beginning program to regain range of motion following an ankle sprain is to ice the ankle for 15 minutes or so.  Then, with the ankle cold and partially numb, draw the ABCs using the big toe as a pencil.  Do this until the ankle begins to become warm. This routine can be done one to three times daily. 


After the initial swelling and inflammation have subsided, moist heat can be useful in treating a sprain.  Moist heat can be applied via a whirlpool, moist heat pack, or damp, warm towel.  Range of motion exercises can be used in combination with the heat treatments.  Always remember that heat should never be applied to an acute injury or one where there is active swelling. 


Over the-counter anti-inflammatory medications can be helpful in treating the initial and long-term effects of an ankle sprain.  Some of these include Advil, Aleve, and Orudis.  Unless otherwise prescribed by your doctor, always follow the dosing instructions on the bottle.  Remember that all medicines have side effects and that you should consult your doctor or pharmacist if you are not sure which medicines are appropriate for you.


Greater than 90 percent of all ankle sprains heal themselves with time and rehabilitation.  A small percentage of ankle sprains will require more aggressive treatment.  The determination of success of conservative treatment is not usually made for several months.  If you still have pain or instability in four to six months after the injury, you should talk to your orthopaedist about a surgical procedure to tighten the ankle or an arthroscopic procedure to evaluate and treat the damage within the ankle.

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