foot/ankle ANKLE SPRAINS
DEFINITION:
- The stretching or tearing of the ligaments surrounding the ankle joint. (See illustration).
MECHANISM OF INJURY / HOW IT OCCURS:
- Often a result of a rapid change in direction such as during a tennis match or while running.
- Can occur with a poor landing after jumping for example while playing basketball – inversion injury.
- Running on an uneven surface with a subsequent twisting maneuver.
SYMPTOMS:
- Immediate pain is the first symptom followed by swelling and bruising.
- A feeling of instability and difficulty bearing weight commonly occurs.
- Individuals may report hearing or feeling a “snap or pop”.
DIAGNOSIS:
- Physical examination reveal swelling and bruising (ecchymosis) to the ankle.
- Tenderness to palpation is evident.
- Instability may be detected but often is difficult to demonstrate initially secondary to discomfort.
- Radiographic studies such as x-ray evaluation should be performed to evaluate for possible fracture as this presents with a similar clinical picture.
- For persistent symptoms further evaluation with more advanced diagnostic studies such as magnetic resonance imaging (MRI) may be required.
TREATMENT/REHABILITATION:
- Initiating treatment early is imperative in the successful management of ankle sprains so as to avoid chronic difficulties.
- R.I.C.E. – rest, ice, compression and elevation are the initial treatment modalities utilized.
- Crutches are of benefit in the acute period to help unload the ankle joint.
- With severe sprains your physician may recommend an ankle brace or even a short course of casting.
- Rehabilitation, often under the guidance of a physical therapist, is an integral part of the treatment plan so as to avoid or minimize the unfortunate scenario of recurrent ankle sprains, an all too common diagnosis. Proprioceptive retraining and strengthening are emphasized. (See exercises for ankle sprains).