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Don't
you just hate it when you come down after slamming a reverse dunk,
shattering the back board, winning the game in overtime to send you
team to the finals and you sprain you ankle on the landing and can't
play in the championship game! Anyone, from the best-conditioned athlete
to the most sedentary person, can incur an ankle injury. Usually,
the cause is accidental (e.g., a jogger steps in a pothole, a pregnant
woman slips getting out of the car, a softball player slides awkwardly
into a base). Right now you're asking yourself, "What exactly
is a sprained ankle; what should I do if I get one; how do I decrease
the chance of owning one?" Funny you should ask.
First of all, an ankle injury usually involves a sudden, unexpected,
loss of balance, resulting in a sharp twist of the ankle. A strain
occurs when a muscle or tendon becomes over-stretched. A sprain
is more serious and occurs when ligaments (the strong connective
tissue that connects one bone to another) become over-stretched.
In some cases, a ligament tears and may pull a fragment of bone
with it. When a piece of bone is pulled away, it is known as an
avulsion fracture. The most common ligaments sprained
in the ankle are the anterior talofibular and calcaneofibular ligaments.
(see Figure 1)
Sprains are graded on a scale of 1 to 3 (mild, moderate, or severe),
reflecting the amount of tearing to the ligaments. To decrease healing
time and discomfort, if you do sprain your ankle, you must first
pay the PRICE (initial 24-48 hours).
- P- Protect from further injury (avoid any activity
which increases pain; i.e.; don't resprain it!)
- R- Rest the injured ankle as much as possible.
Crutches enable movement when necessary without placing weight
on the injury. An air cast or splint may be applied to the ankle
for support and severe sprains occasionally require a hard cast.
- I- Ice the injury to reduce swelling. Ice packs
are usually applied for 20 minutes at a time every hour as long
as swelling persists.
- C- Compression means supporting the ankle and
foot with a firmly (not tightly) wrapped elastic bandage, compression
stocking, or gel wrap. If swelling causes the bandage to become
tight, it should be loosened immediately.
- E- Elevate the foot above heart level to minimize
bruising and swelling. This should be done as often as possible
during the first 48 hours.
With proper treatment, most ankle strains and sprains heal within
2 to 6 weeks. Severe injuries may take as long as 12 weeks. A carefully
monitored program of physical therapy may be required to restore
full muscle balance and strength. This can involve stretching the
Achilles tendon as well as coordination and speed exercises. During
this time, taping or bracing the ankle may be prescribed to provide
support until full function is regained. An injured ankle, even
though healed, may be unstable and prone to recurrent injury. For
this reason, you should take precautions. Use shoes that provide
stability and support, wear a supplemental brace (fitted elastic
wrap), establish a comprehensive strengthening program, and maintain
fitness.
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