Ankle
Sprain (Sprained ankle; ankle injury; ankle pain) |
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What is
an ankle sprain or sprained ankle? |
An ankle
sprain is the most common injury to the ankle and the long term
consequences of an ankle sprain is a common cause of chronic ankle
pain. The most common type is the inversion ankle sprain, in which
the ankle rolls over on the outside.
An ankle
sprain is the stretching and tearing of ligaments - in the sprained
ankle the most common damage is done to the talo-fibula ligament
(if the ankle sprain is worse, the calcaneo-fibula ligament can
also be damaged) - sometimes the tendons also get damaged. |
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Sprained
ankle causes: |
Anything
that makes the ankle 'tip over' increases the chance of an ankle
sprain - this can occur in sport (eg jumping and landing on someone's
else's foot), walking on uneven surface, twisting motions etc.
A number
of factors predispose to ankle sprains:
* poor
rehabilitation of a previous sprained ankle
* poor
proprioception (proprioception is the ability to sense where a joint
is .... if you don't know where your ankle is, the muscles will
not be able to prevent the ankle sprain)
* some
feet are very easy to 'tip over' - this is common in those who frequently
'roll the ankle', without actually doing any damage and spraining
the ankle
* weak
muscles (they are just not strong enough to prevent the sprain occurring) |
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Ankle sprain
types: |
The sprained
ankle is often classified as to how severe it is:
First
degree ankle sprain:
* Some stretching or mild
tearing of the ligament.
* Little or no functional loss - the joint can still function and
bear some weight (...but hurts!!!).
* Mild pain
* Some swelling
* Some joint stiffness.
Second degree ankle sprain:
* Some more severe tearing
of the ligaments
* Moderate instability of the joint
* Moderate to severe pain - weightbearing is very painful
* Swelling and stiffness
Third degree ankle sprain:
* Total rupture of a ligament
- there is a loss of motion
* Gross instability of the joint - joint function is lost
* Severe pain initially followed by no pain
* Severe swelling
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What to
do when it you get an ankle sprain or sprained ankle? |
The sooner treatment
starts for a sprained ankle, the greater chance to prevent chronic
pain and long term instability.
For all grades of ankle
sprain follow the R.I.C.E. principles as soon
as possible:
* Rest
your ankle - do not walk on it.
* Ice
- this helps to keep the swelling down. Use ice on the injury several
times a day for 15-20 minutes (more than 20 minutes is not advised)
* Compressive
bandages are needed to immobilize the ankle sprain and to support
the injury.
* Elevate
the ankle above your heart level for as much as you can for 48 hours.
If the sprain is a 2nd
or 3rd degree ankle sprain, seek professional advice immediately. |
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Sprained
ankle treatment |
If
the ankle sprain is a 2nd degree sprain, then in addition to the
R.I.C.E. principle, a more effective means of immoblising the ankle
(splints) may be needed. Anti-inflammatory medication may also be
used to help.
If the
ankle sprain is a 3rd degree sprain, cast immoblisation is needed
for at least 2-3 weeks. Surgery to repair the ruptured ligament
is ont often needed.
Physical
therapy modalities (such as ultrasound) and manual therapy modalities
(such as friction massage) are often used when the acute phase is
over.
As soon
as treatment is instigated, consideration must be given to adequate
rehabilitation:
* exercises
to increase proprioception
* ankle
braces and strapping to facilitate activity
* muscle strengthening
and flexibility exercises
* gradual return to any
sporting activities
* maintain fitness by
doing alternative activities |
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Exercises
for sprained ankle rehabilitation |
Exercises after the first 48 hours
play a major role in the in the rehabilitation of the sprained ankle
and the prevent of ankle sprains. |
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Range
of motion exercises |
Balance |
Strengthening |
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Initially, start by using a towel to gently
pull the foot towards you. Repeat this several times a day, Later
use calf muscle stretches
against the wall. |
Initially, start by balancing on one foot -
hold for as long as possible - repeat several times a day. Later
a 'wobble' board can be used. |
Initially start by pushing the foot outward
against a wall. Hold for 3 seconds - repeat 20 times, several times
a day. Later use an elastic band that is tied to a heavy object
and move the foot outward against this. |
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This is not a comprehensive ankle
sprain rehabilitation program, but gives an idea of the kind of
exercises that are needed for the sprained ankle. |
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What causes
long term pain after ankle sprains |
The
most common cause for long term pain after an ankle sprain is poor
rehabilitation of a previous ankle sprain. All causes of chronic
pain after an ankle sprain should be evaluation by a health professional.
The common
causes are of chronic ankle pain are:
* poor
rehabilitation
* a fracture
that was not initially diagnosed
* congenital
abnormality
* post
traumatic arthritis
* osteochondritis
dissecans (loose bit of bone in the joint)
* sinus
tarsi syndrome
* syndesmotic
ligament injury
* functional
instability (a feeling of 'giving way')
* ankle
impingement
The list
is complicated and diagnosis of what is causing the chronic pain
after the ankle sprain is not easy. |
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Prevention
of the sprained ankle |
A
number of things can be done to prevent an ankle sprain, especially
if there is a history of recurrent sprained ankles:
* continue
to stretch the calf muscles,
strengthen the muscles and the balance exercises
* use strapping or an
ankle brace
* sometimes a wedge in
the shoe will help prevent the ankle from 'tipping over' - this
is particular helpful in those who 'roll' their ankle a lot
Those who chronically sprain the ankle on
a regular basis usually need surgery to 'tighten' the ligaments
or move a tendon to help stabilise the ankle. |
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Links of
relevance to ankle sprains |
ePodiatry's
resources on the sprained ankle
ePodiatry's
resources on ankle pain
Find
a podiatrist
Ask
a question in the foot health forum about ankle injuries
Foot
care products |
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Purchase
products to help your feet: |
USA & Canada: |
UK & Europe: |
Australia & NZ: |
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Coming |
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ePodiatry
is purely a source of information on the sprained ankle, ankle sprain,
ankle injury and ankle pain and should at no time be considered
as replacing the expertise of a health professional. We recommend
seeking professional advice for a sprained ankle, ankle sprain,
ankle injury and ankle pain and all foot problems before embarking
on any form of self treatment or management. Neither the content
or any other service provided through ePodiatry is intended to be
relied on for medical diagnosis or treatment. Do not delay in seeking
health professional advice because of something seen on ePodiatry.
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©2003.
The information contained on this page about the ankle sprain, sprained
ankle, ankle pain or ankle injury is subject to copyright. No part
of the information contained on this page can be reproduced in any
form without the permission of ePodiatry. |
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Ankle
Sprain (Sprained ankle; ankle injury; ankle pain) |