Ankle sprains are very common injuries. There’s a good chance that while playing as a child or stepping on an uneven surface as an adult you sprained your ankle–some 25,000 people do it every day.
Sometimes, it is an awkward moment when you lose your balance, but the pain quickly fades away and you go on your way. But the sprain could be more severe; your ankle might swell and it might hurt too much to stand on it. If it’s a severe sprain, you might have felt a “pop” when the injury happened.
Even though ankle sprains are common, they are not always minor injuries. Some people with repeated or severe sprains can develop long-term joint pain and weakness. Treating a sprained ankle can help prevent ongoing ankle problems.
A sprained ankle means one or more ligaments on the outer side of your ankle were stretched or torn. If a sprain is not treated properly, you could have long-term problems. Typically the ankle is rolled either inward (inversion sprain) or outward (eversion sprain). Inversion sprains cause pain along the outer side of the ankle and are the most common type. Pain along the inner side of the ankle may represent a more serious injury to the tendons or to the ligaments that support the arch and should always be evaluated by a doctor.
With a mild sprain, the ankle may be tender, swollen, and stiff. But it usually feels stable, and you can walk with little pain. A more serious sprain might include bruising and tenderness around the ankle, and walking is painful. In a severe ankle sprain, the ankle is unstable and may feel “wobbly.”
More about Your Injury
There are 3 grades of ankle sprains:
- Grade I sprains: Your ligaments are stretched. It is a mild injury that can improve with some light stretching.
- Grade II sprains: Your ligaments are partially torn. You may need to wear a splint or a cast.
- Grade III sprains: Your ligaments are fully torn. You may need surgery for this severe injury.
The last 2 kinds of sprains are often associated with tearing of small blood vessels. This allows blood to leak into tissues and cause black and blue color in the area. The blood may not appear for several days. Most of the time it is absorbed from the tissues within 2 weeks.
If your sprain is more severe:
- You may feel strong pain and have a lot of swelling.
- You may not be able to walk, or walking may be painful.
Some ankle sprains may become chronic (long-lasting). If this happens to you, your ankle may continue to be:
- Painful and swollen
- Weak or giving way easily
What to Expect
Your health care provider may order an x-ray to look for a bone fracture, or an MRI scan to look for an injury to the ligament.
To help your ankle heal, your provider may treat you with a brace, a cast, or a splint, and may give you crutches to walk on. You may be asked to place only part or none of your weight on the bad ankle. You will also need to do physical therapy or exercises to help you recover from the injury.
You can decrease swelling by:
- Resting and not putting weight on your foot
Ice it to keep down the swelling. Don’t put ice directly on the skin (use a thin piece of cloth such as a pillow case between the ice bag and the skin) Apply ice every hour while you are awake, 20 minutes at a time and covered by a towel or bag, for the first 24 hours after the injury. After the first 24 hours, apply ice 20 minutes 3 to 4 times per day.
- Compression can help control swelling as well as immobilize and support your injury.
- Elevating your foot on a pillow at or above the level of your heart
- Pain medicines, such as ibuprofen or naproxen, may help to ease pain and swelling. You can buy these medicines without a prescription. DO NOT use these drugs for the first 24 hours after your injury. They may increase the risk of bleeding. DO NOT take more than the amount recommended on the bottle or more than your provider advises you to take. Carefully read the warnings on the label before taking any medicine.
The pain and swelling of an ankle sprain most often gets better within 48 hours. After that, you can begin to put weight back on your injured foot.
- Put only as much weight on your foot as is comfortable at first. Slowly work your way up to your full weight.
- If your ankle begins to hurt, stop and rest.
Rehabilitating your Sprained Ankle
Every ligament injury needs rehabilitation. Otherwise, your sprained ankle might not heal completely and you might re-injure it. All ankle sprains, from mild to severe, require three phases of recovery:
- Phase I includes resting, protecting and reducing swelling of your injured ankle.
- Phase II includes restoring your ankle’s flexibility, range of motion and strength.
- Phase III includes gradually returning to straight-ahead activity and doing maintenance exercises, followed later by more cutting sports such as tennis, basketball or football.
Once you can stand on your ankle again, your doctor will prescribe exercise routines to strengthen your muscles and ligaments and increase your flexibility, balance and coordination. Later, you may walk, jog and run figure eights with your ankle taped or in a supportive ankle brace.
It’s important to complete the rehabilitation program because it makes it less likely that you’ll hurt the same ankle again. If you don’t complete rehabilitation, you could suffer chronic pain, instability and arthritis in your ankle. If your ankle still hurts, it could mean that the sprained ligament has not healed right, or that some other injury also happened.
To prevent future sprained ankles, pay attention to your body’s warning signs to slow down when you feel pain or fatigue, and stay in shape with good muscle balance, flexibility and strength in your soft tissues.
Talk to your provider before returning to more intense sports or work activities.
When to Call the Doctor
You should call your provider if you notice any of the following:
- You cannot walk, or walking is very painful.
- The pain does not get better after ice, rest, and pain medicine.
- Your ankle does not feel any better after 5 to 7 days.
- Your ankle continues to feel weak or gives away easily.
- Your ankle is increasingly discolored (red or black and blue), or it becomes numb or tingly.
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