Sprained ankles need attention
By Jeffrey Bramnick, Pure Matters
Each day, 27,000 Americans sprain an ankle. That's almost 10 million a year, making this simple twist our most common joint injury.
When you sprain an ankle, one or more ligaments on the outside of your ankle become stretched or torn. Ankle sprains most often occur when your toes are on the ground, but your heel is up and you are walking on an uneven surface. Your ankle can turn inward, damaging the ligaments.
"Most people do not seek medical attention. They ignore their sprain or self treat," says Glenn B. Pfeffer, M.D., a past president of the American Orthopaedic Foot and Ankle Society. "The problem is that many people don't realize how serious neglected ankle sprains can be." Untreated, one out of five injuries can weaken an ankle so that people skip or limit some activities, such as hiking.
Recurring sprains can lead to arthritis, tendon injury and an ankle that gives way easily.
"People who have simple strains, or grade 1 sprains, usually don't see a doctor," Dr. Pfeffer says, and they usually don't need to. "When there's a grade 2 sprain or greater, with discoloration and swelling, they're more likely to make an appointment or show up in the ER."
Your doctor may advise you to:
- Immobilize the ankle with an inflatable splint.
- Use the RICE method (rest, ice, compression and elevation).
- Let the ankle bear weight as best you can, using crutches.
- Move the ankle a bit with your health provider's guidance.
- Take anti-inflammatory drugs.
In severe cases, your doctor may put a cast on the foot and ankle for 10 to 14 days.
If you sprain an ankle, Dr. Pfeffer advises wearing a brace for a few months. That's especially wise during high-risk activity, such as playing basketball or volleyball, hiking or just climbing stairs.
Ankle sprains' severity and appropriate treatment:
Grade 1 — A stretching of the ligaments. Treat by using RICE (Rest, Ice, Compression, Elevation).
Grade 2 — A stretching and some rupture of the ligaments. Treat by using RICE and by allowing additional time to heal. A sprain of this severity may need to be splinted.
Grade 3 — Greater rupture of the ligaments. You may need to wear a cast or a cast brace for two to three weeks while the injury heals. Repeated ankle sprains may require surgery to repair the ligaments.
Recovery after a sprain
Whatever the severity of sprain, the ankle needs time to recover. The first step in rehabilitation is to rest the ankle, protecting it from further injury and reducing the swelling by following RICE. The next step is to strengthen muscles and ligaments, and to restore range of motion. The last step involves activities that move the foot in a straight line, followed later by sports that use more cutting movements.
If you sprain your ankle, it's important to follow through with rehabilitation to avoid further injury. Once your ankle is fully recovered, work to keep your ankle in good shape with flexibility and strengthening exercises.
An ankle exercise
When your ankle feels more stable, ask your doctor about this exercise:
Stand on both legs. Brace yourself with one hand. Lift the uninjured leg off the ground by bending your knee. Do this for 60 seconds with your eyes closed. Switch sides and repeat until it's just as easy on both sides. Then, increase the time. This helps restore your sense of "where your injured ankle is in space," Dr. Pfeffer says.
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