A sprained ankle is one of the most common joint injuries, prompting many to consider it “just a sprain” and not treat it with the respect it deserves. The too-common consequence is a lasting weakness: an unstable joint and repeated sprains.
I suffered two memorable ankle sprains and although I did better with the second than the first, in neither case did I do everything right. The first occurred when I twisted my ankle stepping on an uneven surface in my backyard. The pain subsided in a few minutes and I did nothing about it. Nothing, that is, until it began to swell and throb and I couldn’t walk.
The second occurred when I turned my ankle coming down the stairs of a commuter plane. This time the pain was so sever. I had to be carried into the airport, where a wheelchair and ice packs were provided. On my connecting flight, I was given a three-seat row where I could keep my ankle elevated and periodically iced. I slept that night with pillows under my foot. The next morning, the pain was gone and I went jogging.
Two mistakes:
My first injury should have been treated immediately, with rest, ice and elevation and an elastic bandage to keep down the swelling; with the second, I had no business running on that ankle less than 12 hours later.
Ankle sprains are so often mistreated or not treated at all, experts say, that they have the highest recurrence rate of any joint injury and often result in chronic symptoms. Ankle sprains usually need more rehabilitation and take longer to heal than most people think.
According to Tricia Hubbard, undergraduate athletic training director at the University of North Carolina, Charlotte, “Most research shows that, with any ankle sprain, the ankle should be immediately immobilised to protect the joint and allow the injured ligaments to heal: at least a week for the simplest sprain, 10 to 14 days for a moderate sprain and four to six weeks for more sever sprains.
Lack of pain is not the best indicator that it’s safe to resume activity. The pain can subside fairly quickly, but that does not mean the ligaments have healed.”
What to do:
As with other such injuries, the recommended first aid, to be started as soon as possible, goes by the acronym RICE: R for rest, I for ice, C for compression, E for elevation. In other words, get off the foot, wrap it in a bandage, raise it higher than the heart and ice it with a cloth-wrapped ice pack applied for 20 minutes once every hour (longer application can cause tissue damage).
This should be followed by a visit to a doctor, physical therapist or professional trainer, who should prescribe a period of immobilization of the ankle and rehabilitation exercises. An anti-inflammatory drug may be recommended and crutches provided for a few days, especially if the ankle cannot bear weight.
Immobilization provides ligaments with the rest needed to heal and reduces the risk of aggravating the injury. Even a complete ligament tear can heal without surgery through proper immobilization. But this should not be overdone and must be followed by exercises that prevent muscle atrophy and stiffness.
During healing, Hubbard said, “new tissues are laid down, and they need to be aligned with the action of the joint” through proper exercise.
Rehabilitation should include range-of-motion and stretching exercises, strength training and balance training. Even after an injury has healed, an athlete’s ankle often needs extra protection during physical activities.
Of course, preventing injury in the first place is deal. Athletic trainers emphasise the importance of wearing proper shoes for your chosen activity: comfortable, supportive and not worn out.
Hubbard says women should be very careful in high heels or platform shoes, which she called “an ankle sprain waiting to happen”.
