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The Hazards of Ankle Sprains

ankle sprain
Every day in the US, about 28,000 people sprain an ankle. Often the injury is dismissed as “just a sprain,” with no specific treatment and a return to full activity before it has completely healed. Nearly 45% of all athletic injuries are ankle sprains, and players often go back into the game with little or no treatment as soon as the pain subsides.

When To Seek Medical Advice

“In fact, according to the International Ankle Consortium, a global group of researchers and clinicians who study ankle injuries, 55 percent of people who sprain an ankle never seek professional treatment in the aftermath of the injury.”

Unfortunately, the majority of ankle sprains recur because of a chronically unstable joint that tends to “give way,” poor balance, an uneven gait, lack of flexibility, weight gain, or early arthritis. Most ankle sprains happen when your foot suddenly turns in under the leg so that the sole of that foot faces the opposite leg, painfully stretching the ligament on the outside of the ankle. The extent of the injury can range from a minor strain to a complete tear, and the rate and extent of healing can vary greatly.

Should you sprain an ankle, avoid the all too common advice to “walk it off.” At a minimum, leave the game or whatever you were doing and avoid putting weight on that foot to give the injured ankle adequate rest. If the injury is severe, you may need to use crutches.

If you do sprain an ankle, apply ice wrapped in a cloth for 15 to 20 minutes every two or three hours for two days, then once a day until pain and swelling are gone. Sit or lie down as much as possible with the injured ankle elevated above the hip. To further minimize swelling, wrap the ankle in an elastic bandage, starting at the toes and working up to the leg.

Seriously consider a medical consultation, especially if pain and swelling persist for more than a few days. Although in most cases, an X-ray or M.R.I. is not needed to make an accurate diagnosis, the injury could be more serious than a simple sprain. Ask about physical therapy, which can strengthen the joint and help prevent reinjury.

“Dr. Gribble recently presented the latest technical information on ankle sprains to the National Athletic Trainers’ Association meeting in Baltimore. In a study of 3,526 adults who responded to a questionnaire, more than half, or 1,843, had previously sustained an ankle injury. Those who had injured their ankles tended to weigh more, had greater limitations in their daily activities and were more likely to have cardiovascular or respiratory conditions than those who remained injury free.”

Sports and the General Public

While ankle sprains are most common among physically active people, the general public is not immune. The injury can result from walking on an uneven surface (especially while wearing high heels), incorrectly stepping off a curb or staircase, being pulled erratically by a dog on a leash, or even running around playing with children or friends.

“In one report to the athletic trainers’ convention, 12 college students who had sprained an ankle still had an incompletely healed, overstretched ligament a year after the injury, which “may explain the high percentage of patients that develop chronic ankle instability,” said Tricia Hubbard-Turner of the University of North Carolina at Charlotte.”

“Even though fewer than half of ankle sprains receive medical attention, the injury is so common that it is the leading lower extremity injury that results in an emergency room visit, according to data from the National Electronic Injury Surveillance System.”

Prevention is Key

As with any injury, ankle sprains are best prevented. One of the best ways to do this is to improve your balance with flexibility exercises such as standing on one foot, at first on a firm surface, then with eyes closed, then on a soft surface like a pillow. Do stretching exercises that increase the flexibility of the legs, hip and torso to guard against any unanticipated awkward movements.

“When participating in sports like basketball, soccer and tennis — which involve jumps or quick changes in direction that can put ankles at risk — consider taping or bracing the ankles to increase their stability.

Finally, avoid being a weekend warrior who indulges in a sport full tilt without adequate preparation. Build up gradually, practice the skills involved and make sure to keep needed muscles strong.”

Most importantly, do not rush back into activity before healing is complete and normal, pain-free range of motion has been restored.  Reinjuring the ankle can result in permanent pain and disability, so see a doctor if the pain persists.

Originally posted in the New York Times

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