by Dr. Brant McCartan
The most common type of ankle injury is a sprain. Ankle sprains include the lateral (outside) structures of the ankle. Sprains can happen when the ankle is inverted (turned or rolled outwards). A lateral ankle sprain is the result of tears to any of the lateral stabilizing ligaments. For athletes, ankle sprains typically happen when landing jumps, either landing improperly or on an uneven surface. Severe sprains can have an audible ‘pop’ sound.
Upon sustaining an ankle sprain, you will often notice swelling and pain over the lateral ankle. This will vary depending on the severity of the sprain. In the case of some ankle sprains and fractures, it is possible to walk and mistakenly believe that an injury does not require medical treatment. The ability to walk does not mean that your ankle is not broken or badly sprained. Walking on the injury can make the problem worse, and lead to long-term joint pain, and even arthritis later in life.
Bruising is not immediate – it can appear within 1-3 days following an ankle sprain. Immediately apply the RICE protocol.
The RICE treatment protocol:
- Rest – avoid using the injured foot to prevent further damage.
- Ice – apply ice or cold packs to the ankle for 15–20 minutes each hour to help reduce swelling.
- Compression – wrap an ace bandage around the ankle – this will reduce swelling.
- Elevation – elevate above the heart and support the ankle while resting to prevent blood from pooling and increased swelling
Ankle sprains should be evaluated by a podiatric physician to rule out any fractures. It is possible to both fracture and sprain your ankle at the same time– and a bad sprain can hide the fracture. Symptoms of both sprains and fractures can be similar, but fractures are associated with: pain at the site of the fracture that can extend from the foot to the knee, significant swelling, blisters over the injury site, bruising soon after the injury, and bone protruding from the skin. The latter is the sign of a compound fracture, which requires immediate medical attention!
Most ankle fractures and some sprains are treated by immobilizing the join in a cast or splint to encourage healing. Surgery may be needed to repair fractures with severe misalignment to properly unite and realign broken bones. You may be required to keep weight off of the injury – your doctor will monitor your healing and instruct you. Physical therapy and approved exercises both during and after healing will help you regain strength and mobility – avoiding future injury.