ANKLE SPRAINS
AND TREATMENTS
Introduction
Ankle sprains are common injuries that occur
when ligaments are stretched out or torn. The ankle sprain
is the most common athletic injury. Nearly 85% of ankle sprains
occur laterally, or on the outside of ankle joints. Sprains
on the inside ligaments are less common. Many sprains occur
when participating in sports, or by twisting the ankle when
walking on an uneven surface. Some individuals, due to their
bone structure or foot type, are more prone to ankle sprains.
Anatomy of the Ankle Joint
The ankle joint is made up of three bones.
The bones are called the tibia, fibula, and talus. These bones
form a socket in which the ankle joint moves. The tibia, fibula
and talus are connected to each other by ligaments. Think
of ligaments as thick rubber bands that hold bones together
so that joints are stable and function properly. When an ankle
is sprained, a ligament is either stretched, partially torn
or completely torn. Muscle and tendon structures surround
the ligaments. These structures provide motion of the ankle
joint for walking and running. Blood vessels, nerves and skin
overlie the ligaments and tendons. The ankle joint moves the
foot upward and downward. Just below the ankle joint is a
ball and socket type joint that allows inward and outward
motion.
Ankle Injury Symptoms
Ankle sprain symptoms vary depending on severity.
Often, the ankle is tender, swollen, and discolored. The ankle
can be quite painful to touch. Walking is usually hampered
and may become difficult depending on the severity of the
sprain. A feeling of instability may occur, especially in
sever ankle sprains when ligaments are torn. Ankle sprains
are classified by "types" and range from mild to moderate
to severe. Classifying ankle sprains helps the podiatric surgeon
diagnose the specific structures involved in the injury. This
also helps determine appropriate treatment plans for each
type of ankle sprain. Type I ankle sprain, the least severe,
occurs when ligament fibers have been stretched or slightly
torn. Type II sprains occur when some of these fibers or ligaments
are completely torn. Type III, the most severe, occurs when
the entire ligament is torn and there is significant instability
of the ankle joint. Fractures of the ankle bone or outside
the foot bone may be present. Fractures require immediate
diagnosis and attention for appropriate treatment.
Diagnosis
The podiatric surgeon examines the ankle
to identify the type of ankle sprain and determine the appropriate
method of treatment. X-rays or specialized X-ray views of
the ankle and foot may also be used to reveal any fractures,
dislocations or instability of the ankle joint. Less frequently,
more sophisticated testing is necessary to examine soft tissue
injuries. For example, computerized tomography (CT) and magnetic
resonance imaging (MRI) give detailed views of the bone and
soft tissue structures around the ankle joint. Once the diagnosis
is made, the podiatric surgeon recommends appropriate therapy.
Treatment
Initial treatment includes rest, ice, compression
and elevation (RICE). The "RICE" method promotes healing,
decreases pain, and reduces swelling around the ankle joint.
In more severe cases, non-weight-bearing activities are encouraged
and crutches may be recommended. Compression may be achieved
with an elastic bandage, splint, short leg cast or brace,
depending on severity. Compression eliminates motion around
the ankle joint. The ability to walk or participate in other
weight-bearing activities during the healing process depends
on the severity or type of ankle sprain. This is determined
by the podiatric surgeon once the diagnosis is made. Most
ankle sprains heal in three to eight weeks. In more severe
cases, ligaments may require more healing time to promote
ankle stability. Repeated ankle sprains may cause chronic
instability, interfering with walking or sports activities.
In this case, the podiatric surgeon may recommend a surgical
procedure to tighten or create new ligaments around the ankle
joint to re-establish stability of the ankle joint.
Conservative treatment of many foot and ankle
problems often promotes pain relief. For example, ankle strengthening
exercises following the injury help prevent recurrence of
injury. Most of these exercises can be done at home after
appropriate instruction. Ankle supports and braces or taping
around the ankle joint is especially helpful for individuals
participating in sports. Your podiatric surgeon may recommend
preventive bracing to help prevent future injury.
Summary
The adage "it is better to break an ankle
than sprain one" need not apply if the injury is appropriately
diagnosed and treated by the podiatric surgeon. Properly treated,
the rehabilitated ankle can tolerate normal activities and
the stress of participating in sports. The podiatric surgeon
is a foot and ankle specialist who diagnoses foot and ankle
conditions and determines appropriate treatment.
While these are some of the most commonly
prescribes treatments for ankle sprains, others may be used.
The podiatric surgeon will determine which treatment is likely
to be the most successful in each case.
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