Ankle Injuries Deserve More Respect

If you're like most people, you ice your sprained ankle and try and get back on your feet as soon as possible. But there is a twist. By not giving your ankle adequate time to heal, you could put yourself at risk for chronic foot and ankle problems.

"Ankle sprains are one of the most neglected musculoskeletal injuries. We've all had one or know someone who had one, but we take them for granted and under treat them," says Glenn Pfeffer, M.D., director of the Foot and Ankle Center at Cedars-Sinai Orthopedic Center.

Ankle sprains are the most common sports injury in the United States, happening at an incredible rate of 25,000 every day. If your ankle turns sharply inward or outward when you're exercising or participating in sports or even walking in high-heeled shoes, the sudden pulling can stretch or tear ligaments. A sprain causes swelling, discoloration, tenderness and trouble walking.

"If a person cannot hop on the injured foot, then they have a sprain that is worth treating properly," Pfeffer says. The bone may also be broken.

There are three grades of ankle sprains. The amount of force on the ligaments determines the grade level.

• Grade 1 sprain - slight stretching and some damage to the ligament.
• Grade 2 sprain - partial tearing of the ligament.
• Grade 3 sprain - complete tearing of the ligament.

Treatments and exercises you can do at home

Immediate treatment for a Grade 1 or 2 sprain is RICE - Rest, Ice, Compression and Elevation. See your doctor so he or she can determine if an x-ray is needed to rule out any broken bones. For Grade 2 sprains, your doctor may recommend using a splint. Grade 3 sprains are the most severe. Surgery is rarely needed, but a leg cast or brace may be used for the first two or three weeks.

Depending on the grade of your sprain, it may be one to three weeks before you can resume light activity. Your doctor will determine the best schedule for you.

Warming up before exercising is the best way to prevent ankle injury. It is an important step to reducing your risk of chronic foot and ankle problems. The American Academy of Orthopaedic Surgeons recommends making these exercises part of your daily routine:

• Stretch your calf and Achilles tendon. Stand on a stair with one foot just in front of the other. Allow the heel to stretch downward over the edge. The knee is straight. Feel the pull in the calf (Achilles tendon) and the bottom of the foot. Do this for 30 seconds four to six times every day.

• Improve your balance. Stand on one leg with your eyes closed, as long as you can. Build up to 30 seconds. Repeat three times twice daily.

• Strengthen your foot and ankle. Lying on your side, allow the end of your upper leg to hang over the edge of the sofa. Slowly lift your toes toward the ceiling, hold for three seconds and repeat 10 times. Repeat two times each day.

Recovering from an injury also takes time. "People try to get back to business and to sports too fast, too soon and they have inadequate rehabilitation that predisposes them to future injury," Pfeffer says. Some ankle sprains lead to further complications, such as recurring sprains, arthritis, and tendon and cartilage damage, Pfeffer says.

Who is at risk?

High school athletes are all about getting back in the game, which means they are more prone to trying to play sports with a bad ankle. As a parent, you can ensure that your child does not return to the playing field unless the child has fully recovered. The criteria for recovery are full motion, full strength and no pain. Your doctor can determine full recovery.

Here are some injury-prevention tips:

• Follow a year-round training and conditioning program of stretching and strength exercises.

• Check the playing fields you use routinely, and take some time and supplies to fill in the holes and uneven areas.

Sources:

The American Orthopaedic Foot and Ankle Society

The American Academy of Orthopaedic Surgeons

This article was reviewed and updated June 2007.