Ankle Sprain Causes, Symptoms, Treatments, Recovery and Prevention

7 Feb12

I was walking and talking with a friend, didn’t notice that there was some kind of ‘food’ thrown on the floor. Without knowing the walking path leading to this dangerous trap, with the 1.5inches shoes, the ‘food’ on the floor cause a ‘highly slippery’ effect on the landing step. This resulted an inversion injuries, in which the foot rolls inward. About to fall backward, hands just instinctively reached out to grab my friend’s arm, that prevented the fall. However, follow next was the sharp pain sensation..that incident happened in the early morning..on the same night had Physician consultation. Fever on the 3rd day and the pain get worst..

Realized that it will be good that one should know the common knowledge of Ankle Sprain and how to take care..

The following factors can contribute to an increased risk of ankle sprains:

  • Weak muscles/tendons that cross the ankle joint, especially the muscles of the lower leg that cross the outside, or lateral aspect of the ankle joint (i.e. peroneal or fibular muscles);
  • Weak or lax ligaments that join together the bones of the ankle joint – this can be hereditary or due to overstretching of ligaments as a result of repetitive ankle sprains;
  • Poor ankle flexibility;
  • Lack of warm-up and/or stretching before activity;
  • Inadequate joint proprioception (i.e. sense of joint position);
  • Slow neuron muscular response to an off-balance position;
  • Running on uneven surfaces;
  • Shoes with inadequate heel support; and
  • Wearing high-heeled shoes – due to the weak position of the ankle joint with an elevated heel, and a small base of support.When you sprain your ankle there is sometimes a snapping or popping sound and a feeling of ‘giving way’ – this could be a ligament tearing or a bone cracking. A sprain can be very painful with the pain getting worse when you move your ankle. With a severe sprain you may not be able to put weight on your leg.

    Ankle Sprain -Inversion and Eversion

    You may have swelling and bruising. Swelling happens soon after the injury but bruising can take up to 24 hours to fully develop. The swelling around your ankle can make it difficult to move your foot and your ankle may feel unstable.

    Ankle Sprain Symptoms and Signs

Ankle Ligament

Tissue injury and inflammation occur when an ankle is sprained. Blood vessels become “leaky” and allow fluid to ooze into the soft tissue surrounding the joint. White blood cells responsible for inflammation migrate to the area, and blood flow increases. The following are signs and symptoms of inflammation.

  • Swelling: Due to increased fluid in the tissue, this is sometimes severe.
  • Pain: The nerves are more sensitive. The joint hurts and may throb. The pain can worsen when the sore area is pressed or the foot moves in certain directions ie walking and standing
  • Redness and warmth: caused by increased blood flow to the area

If any of the following occur, contact  doctor.

  • Pain is uncontrolled, despite the used of medication, elevation, and ice.
  • Unable to walk or cannot walk more than a few steps without severe pain.
  • The ankle fails to improve within five to seven days. The pain need not be gone, but it should be improving.

Sprained ankles, as with all ligaments sprains, are divided into grades 1-3, depending on their severity:

Grade 1 sprain:

  • Some stretching or perhaps minor tearing of the lateral ankle ligaments.
  • Little or no joint instability.
  • Mild pain.
  • There may be mild swelling around the bone on the outside of the ankle.
  • Some joint stiffness or difficulty walking or running.

Grade 2 sprain:

  • Moderate tearing of the ligament fibres.
  • Some instability of the joint.
  • Moderate to severe pain and difficulty walking.
  • Swelling and stiffness in the ankle joint.
  • Minor bruising may be evident.

Grade 3 sprain:

  • Total rupture of a ligament.
  • Gross instability of the joint.
  • Severe pain initially followed later by no pain.
  • Severe swelling.
  • Usually extensive bruising.

Take note that emergency medical intervention is needed if you have the following symptoms:

  • The sprained ankle is not improving after three to four days.
  • You have a fever and the sprained ankle is hot and red. You may have an infection.
  • You have severe pain in the injured limb and the swelling worsens.
  • There is prominent deformity in the injured area

How can ankle sprains be treated?

 

Self-help

 

Follow the PRICE procedure as soon as possible after injuring your ankle. PRICE stands for the following.

 

  • Protection. Protect your ankle from further harm, for example, by using a support or high-top, lace-up shoes.
  • Rest. Try to rest your injury for the first 48 to 72 hours. Use crutches to help you get around if you need to. After this time, gradually re-introduce movement to the affected area.
  • Ice. Apply ice packs or ice wrapped in a damp towel for 15 to 20 minutes every two to three hours. Never apply ice directly to your skin as it can give you an ‘ice burn’ – always place a cloth between the ice and skin. If you have no ice, you could also use a bag of frozen peas or immerse the area in iced water. This will help to reduce any swelling and bruising. You should try to apply ice for the first 48 to 72 hours after your injury but only when you’re awake – never leave ice on while you sleep. Also, don’t use ice if you have skin disorders that make your skin sensitive. Note that the cold can damage nerves if the ice is left in place too long. Ice can be left on your ankle for up to 20 minutes at a time. When your skin feels numb, it’s time to remove the ice. Use ice treatments every 2 to 4 hours for the first 3 days after your injury.
  • Compression. Compress the area by bandaging it to support the injury and help decrease swelling. You can use a simple elastic bandage to do this or an elasticated tubular bandage. It should fit snugly but not be too tight. Make sure you remove the bandage before going to sleep.
  • Elevate. Elevating your ankle above the level of your heart will help to control the swelling. Use a pillow to keep the area raised. Try to keep it elevated as much as possible until the swelling goes down.

 

It’s important to begin gentle flexibility exercises within 48 to 72 hours of injury as long as it doesn’t cause excessive pain – this will help your injury to heal more quickly. It will also help you regain the full range of motion in your ankle.

 

You could try the following exercises.

 

  • Move your  foot  up and down as though pressing on a car pedal.
  • Make circles with your foot, both clockwise and anti-clockwise.
  • In either a sitting or a standing position, shift your weight from front to back and from the inside to the outside of your foot.
  • Stretch your Achilles tendon (without putting weight on it) – you can do this by using a belt to pull your toes up towards you.

 

How to prevent reinjury?

Once your sprain has completely healed, a program of ankle exercises will also help prevent re-injury by making the muscles stronger, which provides protection to the ligaments. Try the following exercises:

 

Ankle Circles
Sit on the floor with your legs stretched out in front of you. Move your ankle from side to side, up and down and around in circles. Do 5 to 10 circles in each direction at least 3 times per day.

 

Alphabet Letters
Using your big toe as a “pencil,” try to write the letters of the alphabet in the air. Do the entire alphabet 2 or 3 times.

 

Toe Raises
Pull your toes back toward you while keeping your knee as straight as you can. Hold for 15 seconds. Do this 10 times.

 

Heel Raises
Point your toes away from you while keeping your knee as straight as you can. Hold for 15 seconds. Do this 10 times.

 

In and Out
Turn your foot inward until you can’t turn it anymore and hold for 15 seconds. Straighten your leg again. Turn it outward until you can’t turn it anymore and hold for 15 seconds. Do this 10 times in both directions.

 

Resisted In and Out
Sit on a chair with your leg straight in front of you. Tie a large elastic exercise band together at one end to make a knot. Wrap the end of the band around the chair leg and the other end around the bottom of your injured foot. Keep your heel on the ground and slide your foot outward and hold for 10 seconds. Put your foot in front of you again. Slide your foot inward and hold for 10 seconds. Repeat at least 10 times each direction 2 or 3 times per day.

 

Step Up
Put your injured foot on the first step of a staircase and your uninjured foot on the ground. Slowly straighten the knee of you injured leg while lifting your uninjured foot off the ground. Slowly put your uninjured foot back on the ground. Do this 3 to 5 times at least 3 times per day.

 

Sitting and Standing Heel Raises
Sit in a chair with your injured foot on the ground. Slowly raise the heel of you injured foot while keeping your toes on the ground. Return the heel to the floor. Repeat 10 times at least 2 or 3 times per day. As you get stronger, you can stand on your injured foot instead of sitting in a chair and raise the heel. Your injured foot should always stay on the ground.

 

Balance Exercises
Stand and place a chair next to your uninjured leg to balance you. At first, stand on the injured foot for 30 seconds. You can slowly increase this to up to 3 minutes at a time. Repeat at least 3 time a day. To increase the difficulty, repeat with your eyes closed.


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