Some Thoughts on Ankle Sprains

Our ankles take a lot of abuse. Not only do they have to steady us as we walk, they also must be able to withstand sudden changes in force or direction. Take basketball, for example. Here is a sport where you could be running one minute, jumping the next or turning around a few seconds later. When the ankle is subjected to sufficient force, a sprain will occur.

Just what is a sprain? A sprain involves a tear of the ligaments or the bands which hold a joint together. The ankle has two main ligaments-one on the inside, which is stronger but not quite as flexible and one on the outside which trades increased flexibility for less strength. When the foot is flat on the ground, the angle with the rest of the leg is about 90 degrees. At this point the ankle is at its strongest. However, if the foot extends itself, say to propel your self forward (think walking or running) or to jump it becomes much weaker. Hence most ankle injuries occur during that time in which the foot does not make that magic 90 degree angle-ie is not flat.

If you sprain your ankle you often will feel a pop. Most commonly this is due to the ligaments tearing, but in severe sprains can also arise from the ligament actually pulling a piece of bone off or  from the bone just breaking. Most sprains occur on the outside, where the ankle is at its weakest. Sometimes it happens on both sides, which as you can imagine, does not feel that good.

Most sprains will heal within a few weeks, but it is very important to stabilize the ankle. Why? If the ligament is torn and then during the daily routine is constantly reinjured, it might heal loosely. This turn could make it easier to sprain the ankle and down the road might even cause arthritis. A good ankle brace should allow the foot to move up and down while providing strong support against sideways motions. Wear the splint for a couple of weeks if you are young or it is a mild sprain and for a month or so for worse sprains or for middle age plus weekend warriors.  Ice initially followed by heat is a good idea.

When should you bite the bullet and go to the emergency room? If you can’t put weight on the ankle because of pain or instability; when the pain and or swelling is severe; when there are other injuries as well.  Antiinfllammatories (read Ibuprofen) are a good idea as well. Rest and elevate the ankle for a day or so. After that, start walking at first on flat surfaces but then on hills, taking care to always have the splint on.  Too much rest will stiffen up the ankle, making it harder to heal. Stretch those calves as well.

With a little luck you can go out and play yet another game of tennis where you might just injure that shoulder. But hey-what’s life without a little risk?

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