Ankle sprains are an extremely common injury. They can occur during several types of activities. Ankle sprains commonly occur on the outside of the ankle and may cause partial or full tears of the ankle ligaments. Ankle sprains can occur on their own or with an ankle fracture. In my practice many people who come to see me with an ankle sprain were playing a sport, exercising or took a wrong step and “rolled” their ankle. High heels can also lead to a higher incidence of ankle sprains because of the increased instability of the rear foot and ankle. People with certain foot structures may also be more prone to ankle sprains such as those with high arches.
Some symptoms of ankle sprains include; ankle pain when walking, again commonly on the outside or lateral aspect of the ankle, limping, swelling around the affected area and may or may not have bruising or bleeding under the skin.
An ankle sprain should be taken seriously. According to Dr. Lady DeJesus, a board certified podiatrist in New York City; "If you injured your ankle while playing basketball, do not remove your high top sneaker immediately, as the high top acts as a compressive device. If you cannot walk or put pressure on your foot, it may be more than just a sprain. Professional medical attention may be necessary along with an x-ray evaluation." It is important to see a doctor in order to make sure you did not break any bones or rupture any soft tissue structures.
Dr. DeJesus discussed some things you can do at home immediately after an ankle sprain: ice the ankle, take anti-inflammatory medications, compress the area with an ace bandage or ankle sleeve, and use two pillow elevation. Dr. Tiffany DeLutis agrees, she stated that rest, ice and anti-inflammatory medication are some initial treatments following an ankle sprain. Dr. DeLutis also related; "If you do twist your ankle try to walk for a couple of minutes and stretch it out. Do not push through the pain because that could cause serious damage."
When to see a doctor? If your ankle becomes very swollen, you cannot walk on your ankle, it looks mal-aligned or the pain is persisting more than 24 hours without relief. "When you get to your doctor, The most important thing is to ask for an x-ray to verify correct ankle alignment and no broken bones," says Dr. DeLutis.
After initial treatment of 4-5 days, or once ankle pain and swelling have diminished, treatment of ankle sprains should be functional i.e. focus on early mobilization exercises for balance, proprioception, range of motion and lower leg muscle strength. Your doctor may give you exercises to help with rehabilitating your ankle and or send you to see a physical therapist. Dr. DeJesus has her patients rehabilitate their ankle sprains using balance boards, resistance band strengthening exercises, and range of motion exercises.
Other successful treatments consist of ankle taping and bracing. Ankle taping and bracing are commonly used in athletes particularly sports like basketball, tennis, soccer and other field sports that tend to have a higher incidence of acute lateral ankle injuries. Ankle taping may cause more skin irritation and less biomechanical support in comparison to ankle braces. Ankle braces are great for proprioception and biomechanical support. More companies are making ankle braces that fit smoother and give appropriate support while not being too rigid.
If ankle pain persists or worsens with treatment an MRI or CT scan may be necessary to rule out ligament or tendon tears and osteochondral lesions. These issues should be discussed with your doctor and may require surgical intervention.