ANKLE SPRAINS

An ankle sprain is among the most common athletic injury with nearly 90% of occurring to the outside ankle joints. It typically occurs during sports or walking on uneven surfaces where the outside ankle rolls over itself. Some individuals are more prone to the condition due to their bone structure and foot type. Typically, individuals with high arches are more vulnerable to have the injury.

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By definition, a sprain is a stretch or tear of the ligaments that hold the ankle together. When an injury occurs, one or more ligament(s) stretches beyond its norm. This will cause the body to respond to the injury with inflammation, resulting in the classic symptoms seen.

An ankle sprain is often classified into 3 categories to help diagnose the specific structures involved. It becomes very useful for treatment planning and guiding the patient to the best means of recovery.

Type I

  • Ligament fibers have been stretched or slightly torn
  • Usually only 1 ligament affected
  • Least severe

Type II

  • Some of ligament fibers usually completely torn
  • Usually 1 or 2 ligaments affected
  • Moderately severe

Type III

  • Ligament fibers are completely torn
  • Multiple ligaments affected
  • Instability of ankle joint
  • Possible chip fracture to bone connected to ligament
  • Most severe

The risk factors for individuals to have a gout attack is often inherited. However, there are other factors that put patients at high risk. These include high blood pressure, diabetes, obesity, chemotherapy, and stress. Also, certain medications such as diuretics, niacin and aspirin can make an individual susceptible to the condition.

SYMPTOMS

  • Swollen and tender ankle with possible bruising
  • Painful to touch or walking
  • Difficulty walking, feeling on instability

ANKLE FRACTURES

It is not uncommon to see an ankle bone fractured after any type of ankle sprain. Ankle fractures have the same mechanism as a sprain and cannot be ruled out when assessing ankle pain. An x-ray will always be taken to rule out a fracture. Depending on the findings, additional diagnostic imaging such as MRI or CT exam may be indicated if more information is needed. A treatment plan would be formulated accordingly.

TREATMENT

The key to treatment of ankle sprains is long term prevention. Once a ligament is stretched or torn, it loses its integrity and can permanently lengthen. In doing so, the ligament becomes less taut and its strength becomes less effective. The ankle will be instable and prone to future injuries. Treatment usually entails immediate relief of symptoms and return to activity, followed by strengthening and prevention methods.

Typically, an ankle sprain can take 3-6 weeks to fully heal. Initial treatment includes “RICE” therapy, where rest, ice, compression and elevation help promote healing. Compression, ice and elevation will help relieve swelling and pain, while rest from activity will prevent the healing process from being delayed.

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A fracture or walking boot is often dispensed to immobilize the ankle in a relaxed and fixed position, eliminating the motion of the ankle joint and allowing optimal conditions to heal. If severe, crutches may also be indicated. Prescription medications are usually dispensed during this initial treatment to fight the inflammation, reducing swelling and pain.

Once the acute stage of injury is healed, the ankle joint is assessed and strengthened with initiation of stability protocols. This can entail a variety of measures including ankle braces, ankle sleeves or shoes with ankle support. Physical therapy may be necessary at times.

In instances where repeated ankle sprains and feeling of instability is seen, an MRI may be indicated to assess ligaments and soft tissue structures of the ankle joint. The findings will help guide treatment options, which may indicate a surgical procedure to strengthen and recreate tautness to the damaged ligament(s). The recovery time for that type of procedure is usually 4-8 weeks.

If you are exhibiting early indication of pain or discomfort, visit your podiatrist at Premier Foot & Ankle for care!

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