Proper Care for a Sprained Ankle
“Oh it’s just a sprained ankle - I will be fine.” I will bet you have heard this several times from a family member or friend. As an athletic trainer, I have heard this statement many times from athletes and physical therapy patients. But some research studies suggest that as high as 40% of people with simple ankle sprains develop chronic ankle instability and pain following an ankle injury. These chronic problems are often the result of inadequate rehabilitation, or no treatment at all. Individuals who have ankle sprains need to regain normal strength and motion. If they don’t get their strength back to normal, they tend to have a chronically swollen ankle that is clinically and functionally unstable. Walking on uneven ground and unstable surfaces becomes very difficult, the ankle tend to roll inward and recurrent sprains occur, this individual becomes apprehensive about activities that stress the ankle. The good news is that chronic problems can be avoided with proper rehabilitation.
Acute ankle sprains are a very common injury, these injuries occur during athletic activities, on the job site, or even just walking in your backyard. Studies have shown that roughly 85% of all ankle injuries involve some degree of sprain of the ankle ligaments. Of these, 85% are inversion sprains of the lateral ligaments.
Orthopedic surgeons use a grading system to describe ankle sprains. Patients whose injury involves only a mild stretch of the ligamentous fibers--a grade 1 sprain--are usually able to bear weight on the ankle immediately following injury. Patients who have grade 2 sprains, in which there is some tearing of the ligaments, generally present with more significant swelling, but they generally can bear some weight on the ankle. A complete tear of one or more ligaments is classified as a grade 3 sprain. Patients usually present with significant swelling and bruising and may demonstrate functional and clinical instability of the ankle.
So what should you do if you sprain your ankle? Remember the word RICE, (rest, ice, compression, and elevation). Proper use of compression is without question the most important measure. The goal is to prevent swelling, bleeding, and edema around the joint capsule of the ankle, which will result in loss of motion. If you lose motion, you’ll lose strength, and it’s difficult for patients to regain strength and motion of the ankle. The more swelling you can prevent, the quicker the recovery. Use an elastic wrap, neoprene sleeve, or an air-cast to compress the ankle for the first 48 hours and then most of the swelling should stabilize. Apply an ice bag or cold pack to the ankle for 15 minutes; this should be repeated every 2 hours for the first 48 hours, never apply heat during the first 48 hours. To get it elevated, lay on your back and elevate the ankle with 2 or 3 pillows - your ankle should be raised above the level of your chest.
If you have any questions about ankle injuries, contact Tony Andreko PTA/ATC, Moscow ProCare Physical Therapy. 570-842-8191.