Ankle Sports Medicine: Sprains

ankle sprainWhether you are a competitive athlete preparing for your next challenge or a relaxed retiree enjoying a daily morning stroll, we can all agree on one thing: injuries are frustrating! They are unannounced, unforgiving setbacks that leave us grimacing and wondering about the future. What does this injury mean for my daily routine? How will this affect my training schedule? When will I be able to return to full strength? These are common questions we ask ourselves, and while the answers might initially seem vague or unachievable, knowing exactly what the injury entails can allow us clarity.

Injuries of the lower extremity are among the most common sports injuries. The ankle is highly susceptible to injury due to its anatomical constraints and mechanical demands. Walking produces stress through the ankle joint up to 1.5 times your body weight, while stress produced running can be as high as 8 times your body weight. And with the average adult accounting for approximately 5,000 steps per day, accidents happen.

Ankle sprains are one type of said accidents. These injuries commonly occur as the foot rolls outward and the ankle comes over the top, but may result from the opposite mechanism as well. In either situation, the most important thing to do following an ankle sprain is to be a “R.I.C.E. Pro!”

  • R: Rest the extremity and cease activity; immobilize the ankle as best you can.
  • I: Ice the affected ankle routinely for 20 minutes on, 20 minutes off.
  • C: Compress the ankle with ACE bandage or other device. Leave on shoe gear if possible.
  • E: Elevate the ankle above the level of the heart.
  • Pro: Seek a professional opinion. Ankle sprains can appear similar to ankle fractures, and something seemingly innocuous might require extra attention. It is imperative that a specialist makes this distinction in order to expedite your treatment plan and recovery.

Your doctor will be able to classify your ankle sprain into one of three grades of severity:

  • Grade 1: (Mild) Slight stretching of ligament, mild tenderness and swelling
  • Grade 2: (Moderate) Partial tearing of ligament, moderate tenderness, increased looseness
  • Grade 3: (Severe) Complete tear of ligament, significant tenderness/swelling, substantial instability

This grading system serves to appropriately guide therapy and can maximize your outcome while minimizing downtime.

Acute ankle sprains generally do not require surgery. However once the integrity of your ankle is compromised, it is unlikely to be the same again. One ankle sprain serves as a precursor for a second ankle sprain, and chronic instability can ensue. Early physical therapy has been shown to slow and prevent this from occurring, and it is important to initiate a protocol as soon as the patient is able to tolerate manipulation.

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