Dealing with those nasty ankle sprains
About the article
This is a digitised version of an article from The Cayman Compass's print archive. Occasionally, the digitisation process introduces transcription errors, or other problems.
See the article in its original context from June 1998.
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Ankle joint injuries account for a large part of the injuries seen by medical professionals.
The reason for this is because the ankle is a main joint that is involved in daily weight bearing activities and is therefore is at more of a risk for injury. The ankle is susceptible to being injured not just on the playing field or court but also during any daily activities like stepping down from the curb.
The most common way the ankle is injured is from rolling over the out-. side of the ankle. During the roll the foot is in a pointed and turned-in position that puts the ankle joint as its most unstable position. If it lands in this position, the ankle is more susceptible to being sprained. An injury to the ankle joint can affect may different structures. The most common area being the three ligaments on the outside of the ankle whose job is to stabilise the joints together and limit any excess movement. The degree of the sprain depends on the velocity of the movement, the extent of how far the ankle rolls over and the amount of body weight and force on it.
Ankle sprains are graded into three degrees of severity that determine how long it will take before it returns to full activity. In terms of occurrence the first degree is the most common, and if not neglected, the most minor. The ligaments become stretched and have little swelling and no instability. The individual is back to activities within a couple of weeks. For second degree sprains, the ligaments are partially torn and the ankle experience swelling and bruising which can last for a couple of days. This usually requires at least 3-5 weeks before return to full activity.
Finally, when the ligaments have been completely ruptured and many require surgery, the unfortunate individual has experienced a third degree sprain. This can take up to 3-5 months for the ankle to be fully headed.
Any degree of sprain can develop into a chronic problem if not treated properly. This can cause a development of scar tissue on the ligament that hinders its strength and also the flexibility of the joint. However if treated quickly and properly the ankle should heal properly which will allow a safe and early return to activity.
The objective for ankle injuries and for all injuries is to an early return to normal function. The treatment for an acute injury is to follow the "Rice" recipe. This should be initiated for the first 48-72 hours immediately after the injury in order to help decrease pain and swelling. "Rice" stands for. Rest. Ice; apply for 15-20 minutes every 2 hours. Compression, with an Ace bandage will help limit swelling; and Elevation; to help reduce swelling, inflammation and pain.
After the initial 48-72 hours, depending on the severity, incorporation of physical therapy modalities, exercise specific to the stage of healing and education is essential.
When ligaments are stretched or torn they never return to their normal length (their pre-injury state), therefore the muscles must be strengthened in order to stabilise the ankle. The most essential aspect of the rehabilitation is the emphasis on strengthening for the ankle joint and balance control. Studies show that no human can react within 1/10 of a second, therefore you could be as strong as an ox and yet a fast, forceful movement can easily still cause an ankle injury. In order to present re-injury proprioception training, (feedback to the brain of the extent of join and direction of movement) and kinestheric awareness (the body's perception of the joints or limbs in space) is essential. If the above rehabilitation is performed, then chronic ankle injuries can be avoided. One has to make sure the ankle is strong muscularity and proprioceptively before returning to activities.
Vigorous activity on an incomplete healed injury can lead to re-injury and increase the chances of a chronic problem.
Consult a physiotherapist or physician for further information on specific rehabilitation exercises for the ankle. Marcy McCaw is a physiotherapist with Cayman Medical Centre.
