Understanding, Diagnosing and Treating Ankle Sprains

Sprains and strains are the most common sports injuries. More specifically, ankle sprains occur more frequently than any sports injury, according to WebMD, ahead of groin pulls, hamstring strains, shin splints, and ACL tears in the knee.

In the simplest of terms, an ankle sprain is caused by a stretching or tearing of the ankle ligaments. Ankle sprains typically occur after the ankle is twisted, or the foot rolls underneath the ankle.

Although ankle sprains are the most common sports injury, you don’t have to dunk a basketball, catch a touchdown pass, or hit a 300-yard drive to get hurt. In fact, people who don’t get enough exercise and sit around all day are very susceptible to ankle sprains because the ankle hasn’t been conditioned to handle activity.

If you think you’ve sprained your ankle, contact your doctor right away and proceed with the RICE protocol – rest, ice, compression and elevation – to reduce inflammation.

Even if you can walk, stay off your feet immediately after the injury and let the healing process begin. To reduce swelling, ice to the injured ankle four or five times per day for about 20 minutes each time for 24-72 hours. To control swelling and bleeding, apply an elastic bandage or wrap from the toes to the middle of the calf to provide compression, and keep your ankle elevated above the heart. If your toes feel numb or start to turn blue, loosen the elastic wrap.

An ankle sprain is diagnosed during a physical exam by a qualified doctor, such as an orthopedist, chiropractor or physical therapist, who will manipulate the joint to assess your range of motion and look for tenderness or pain in certain positions.

This allows the doctor to determine which ligaments have been injured and the severity of the ankle sprain. Physical therapy and rehabilitation are critical to improving strength, stability and range of motion.

The doctor will recommend an x-ray, MRI or CT scan if the ankle sprain is thought to be severe or other damage in the area may exist.

Ankle sprains are classified according to three grades of severity:

• Grade 1 ankle sprains involve minor stretching or tearing of the ligaments and pain, swelling and stiffness. A person with a Grade 1 ankle sprain can usually walk with a limp.
• Grade 2 ankle sprains involve more severe pain and swelling, as well as bruising. A person with a Grade 2 ankle sprain will find it very difficult to walk.
• Grade 3 ankle sprains involve a complete tear of the ankle ligaments. In most cases, someone with a Grade 3 ankle sprain can’t walk or put any weight on the injured ankle.

According to “Beyond RICE and Rehab,” an article written by Dr. Manuel A. Duarte and published in Chiropractic Economics, as many as half of ankle sprains result in long-term pain, instability, reduced range of motion and strength, and loss of balance.

That’s why it’s important to go beyond RICE in many cases. Newer rehabilitation protocols designed to stimulate nerve activation and muscle control are becoming more popular, and custom orthotics are often used to treat chronic ankle instability.

Of course, the worst thing you can do with any injury is tough it out. That pain and swelling are our body’s way of telling us something is wrong. Pay attention to your body, and take care of your body before you try to take care of anything else.