SCRIPT NUMBER 82 SPRAINED ANKLE (TWO SPEAKERS) PROGRAM NAME: HEALTH NUGGETS PROGRAM TITLE: SPRAINED ANKLE PROGRAM NUMBER: 82 SUBJECT: PATHOLOGY, CAUSES, DIAGNOSIS, TREATMENT, PREVENTION OF SPRAINED ANKLES KEY WORDS: LIGAMENTS, INSTABILITY, RANGE OF MOTION, X-RAY, BONE SCAN, WALKING BOOT, BALANCE TRAINING, COMPRESSION DATE OF SCRIPT: OCTOBER 19, 2012 AUTHOR: RICHARD YUKL, MD, FACS In each of our health talks, we try to bring to you, our listener, important information concerning a medical condition that you may encounter, and one that is important to your long-term health. Many of the talks relate to medical conditions that are dangerous enough that they could shorten your life if not treated properly. Today, we want to go a different direction, not talking about a condition that will shorten your life, but one that can make your life miserable. We want to talk about sprained ankles, the most common injury caused by physical activities such as running or participating in sports.
Tough bands of tissue called ligaments hold the joints in our bodies together, keeping them in proper position. In the ankle, a sprain occurs when the ankle joint is forced to move out of its normal position to such an extent that these ligaments stretch or tear. Most sprained ankles involve injuries to the ligaments on the outer side of the ankle, and some people can actually hear or feel a "pop" at the time of injury. Give me examples of situations that cause ankle sprains Common examples include falls in which the ankle twists, or landing awkwardly on your foot after walking or jumping on an uneven surface. The activities that pose the greatest risk, however, involve playing sports, because you must roll or twist your foot in sports such as basketball, tennis and soccer. That can sprain your ankle, especially if you're overweight. Playing sports on an uneven surface increases your risk even more. Also, a prior ankle sprain increases your risk. A prior ankle sprain doubles your risk or reinjury for at least one year. What are the symptoms of a sprained ankle? Symptoms include pain, especially when you step on the injured foot, swelling, and, sometimes bruising and an inability to move the ankle joint normally. What is important for you to understand is that, without proper treatment, ankle
sprains can develop complications that can cause you long-term physical disability. Your ankle joint can become unstable, it can develop arthritis that causes you to have chronic pain, and it can create the high likelihood that you will reinjure your ankle. Disability caused by up to fifty percent of these repeat injures will require prolonged medical care. What is the proper treatment of a sprained ankle? It depends on the severity of the injury. If the pain and swelling are only mild, many people simply choose to treat their injury at home. In most cases, pain-relieving medicines that you can buy without a doctor s prescription are enough to manage the pain caused by a mild sprain. Tell me the specifics of how I should treat my mildly sprained ankle at home. Treatment should involve rest, ice, compression and elevation. By rest I mean that you avoid all activities that cause your injured ankle pain, swelling or discomfort. What about ice? Ice the injury immediately. Place an ice pack on your ankle for 15 to 20 minutes, and repeat it every two to three hours while you're awake for the first two to three days. Cold reduces the pain, swelling and inflammation. It can also slow bleeding if a tear has occurred.
Also, to help reduce the swelling, compress your ankle with an elastic bandage. Begin wrapping at the end furthest from your heart, and don't wrap it too tightly or you may slow blood from flowing to your foot. Loosen the wrap if the wrapping causes your pain to increase, or your foot to swell more or become numb. You can further reduce the swelling by elevating your ankle above the level of your heart, especially at night. Gravity helps reduce the swelling by draining excess fluid. A few days after your injury, when the swelling has eased, a doctor or a physical therapist can instruct you in exercises that you can do to restore your ankle's range of motion, strength and flexibility. Balance training is especially important, as it helps to equalize muscle movements around the injured ankle, keeping it in proper position. Balance training involves exercises such as balancing while standing on one leg. What should I do if my symptoms are severe? Now comes the important information for you to know. If your symptoms are severe, or if your ankle joint is unstable, you need to seek medical attention. Your doctor will identify your specific injuries and the limitations of your ankle s range of motion. X-rays or a bone scan may be required to rule out a broken bone, or to more precisely identify the extent of the soft tissue damage. Your doctor will be able to direct the proper treatment for your specific injury, to allow it to heal properly. You may need to be fitted with a cast or walking boot to prevent your ankle from moving out of proper position. In rare cases of severe
ligament tears, you may even need surgery to repair the damage. How can I lower my risk of spraining my ankle in the first place? Stretch your muscles gradually before you exercise or play sports. Be careful when you work, walk or run on an uneven surface. Wear shoes that fit you well, and that are made for the type of activity you will be doing. If you are a woman, don't wear high-heeled shoes. Don't play sports or participate in activities for which you have not trained. Finally, maintain good muscle strength and flexibility, and practice stability training that includes balance training. Health Nuggets is written by Dr. Richard Yukl, a medical doctor working in the United States. The medical views expressed in this program are his and may differ for your particular health needs. If you need medical advice, please consult a medical professional in your area.