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Sprained Ankle Encore

By Alan Williams, PT, OTR/L, ATC, CSCS

I see it all the time. Their stories may be different, but the underlying problem is the same. Whether it’s the runner desperate to be ready for her next marathon, the high school football player unable to make it through practice, or the frustrated retiree who just wants to enjoy his morning walks, thousands of Americans each day deal with the pain and inconvenience of a sprained ankle. Though it’s one of the most common orthopedic injuries, nearly all sprained ankles are easily treated. However, one sprain often leads to another…and another, and before you know it, you’ve developed chronic ankle problems. By the time someone makes an appointment with me, they’re usually frustrated, in pain, and at a loss for what to do next.

The anatomy of an ankle sprain is pretty simple. In addition to muscles, the ankle is supported by ligaments that hold the bones together. As you pivot, twist, and turn your way through your day, the ligaments stretch slightly to allow for movement and then return to their normal length. A sprain happens when a ligament is forced to stretch too far, resulting in a partial or complete tear of the ligament fibers. It sounds bad, but fortunately tearing a ligament in your ankle is not like tearing one in your knee (which almost always requires surgery). With the proper rehabilitation, ankle ligaments can usually heal without surgery.

Medical professionals use three grades to judge the severity of an ankle sprain. A grade 1 sprain is mild and characterized by light pain and swelling; the patient is able to do guarded weight bearing. Persons with grade 2 sprains see more pain, swelling, and perhaps bruising; they will have difficulty bearing weight for a longer period of time. But persons with grade 3 sprains experience a significant amount of pain and are unable to put any weight on their ankle, often saying it feels as if it will give out from under them.

The primary requirement for successful rehabilitation of a sprained ankle is rest, although how much rest depends on the severity of your sprain (anything greater than a grade 1 sprain should be checked by a physical therapist or doctor). The most common mistake people make when trying to recover from a sprained ankle is returning to activity too soon. When you sprain your ankle, the tears in the ligament fibers heal over with scar tissue. This scar tissue is less elastic than the ligament fibers, making it weaker. Returning to activity without giving the ligament enough time to achieve a complete recovery makes you more vulnerable to future sprains.

When recovering from a sprain, return to activity gradually. Do a little each day, and as you feel stronger, do a little more and a little more until you are up to 100%. This process may take 4-6 weeks for even mild sprains. Listen to your ankle – getting it back into shape is going to hurt, but if the activity is overly painful, decrease the intensity. Conversely, you must challenge your ankle to get it back into shape. An ankle that doesn’t move will never regain the strength and flexibility it needs to function.

To treat a sprain, use the R.I.C.E. method: Rest the ankle from all weight bearing activities; put Ice on the injury for 20 minutes at a time, several times a day; gently Compress the injury with a wrap or bandage to deter further swelling; Elevate the ankle about 12 inches above the level of the heart to encourage dispersal of any blood that’s pooled in the foot. And sorry, sitting in your recliner with your feet up doesn’t typically get the job done.

Many times a sprained ankle cannot be avoided. We’re only human after all, and accidents happen. But with the correct care and adequate rest, your ankle will heal properly, and you can help keep your sprain from coming back for an encore.

For your FREE Ankle Pain Assessment, call 463-0022 today!