Help for ankle sprains

Ankle sprains the most common of all joint injuries. Ankles are vulnerable because these complex structures of bones, ligaments, tendons, and muscles support your entire body weight and, when you run or jump, may transmit a force of impact equal to three to four times your weight. They can be surprisingly fragile, and all it takes is a little clumsiness or bad luck for a sprain to occur.

An ankle sprain typically happens when your ankle or foot twists while running or walking on uneven ground, or you land awkwardly while playing a sport or miss a step on the stairs. High heels are leading culprits. More than 80 percent of sprains result from the foot rolling inward, injuring the ligaments on the outside of the ankle. The result: overstretching and usually some degree of tearing of one or more of the ligaments stabilizing the bones of the joint.

Assessing ankle sprain damage

Many ankle sprains are minor and can be self-treated at home, but it’s often difficult to determine their severity on your own. And even minor sprains shouldn’t be taken lightly. Without proper treatment and rehab, ankle sprains can lead to long-term problems—notably chronic ankle instability, leg muscle weakness, and more general biomechanical and balance problems—which contribute to increased risk of re-injury. About 30 percent of ankle sprains result in chronic instability, according to researchers from the University of North Carolina, writing in Sports Medicine in 2013. When in doubt, the best course of action is to have a medical evaluation as soon as possible.

The symptoms of an ankle sprain are pain, tenderness, and swelling, usually occurring quickly but sometimes delayed for hours. Sprains are graded as mild (the ligament is just overstretched, usually with microscopic tears), moderate (a partially torn ligament), or severe (a complete tear, meaning that the ligament can no longer stabilize the joint). If you can’t put weight on the foot because of pain or weakness, the swelling is significant (especially all around the ankle), or the skin around the ankle is visibly bruised, it’s probably a moderate or severe sprain (or even a fracture) and you should contact your doctor’s office or go to the emergency room.

Self-care for a sprained ankle

When treating a new sprain, remember RICE: Rest, Ice, Compression, Elevation.

Rest the ankle during the first 24 to 48 hours after the injury. Keep weight off it—by using crutches, for instance—and avoid any activity that causes pain. But don’t overdo rest; get mobile as soon as the pain and swelling decrease and you can begin to bear more weight on that foot.

Ice the ankle as soon as possible to reduce pain, inflammation, and any further bleeding into the joint. Apply ice for 20 minutes every two waking hours, until the swelling subsides, usually in 24 to 48 hours. If it remains swollen, continue icing.

Compress the ankle: Keep it wrapped in an elastic bandage at all times except when bathing; start from your toes and wrap up toward your lower leg. Be careful not to wrap it too tight.

Elevate your foot as much as possible until the swelling disappears. This helps fluids flow away from the injury, decreasing swelling and pain. When seated, elevate your foot to waist level if you can; when lying down, elevate your foot slightly higher than your heart.

If after about 48 hours of self-treatment you still can’t put your full weight on the foot because of continuing or increasing pain and swelling, consult your doctor.

It takes a mild sprain about 10 days to significantly improve (but often longer for strength and full range of motion to return), and up to eight weeks for a moderate sprain.

Once the swelling has subsided and as soon as the pain allows, you should start gentle stretching and weight-bearing exercises. Soon after that, start doing strengthening exercises.


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