So school has once again begun and school sports of course are beginning as well. This is when we as Podiatrists experience many injury visits. According to studies, 40% of all sports injuries are ankle sprains. The most common age groups for these sprains are between the ages of 15 and 19. Proper ankle sprain care can prevent long term and recurrent ankle problems.
Unfortunately, injured high school athletes return to the field much sooner than they should leaving them susceptible to re-injury or chronic long-term ankle pain. According to researchers, more than half of first time ankle sprains will develop long-term symptoms or what we in the profession call chronic ankle instability.
Ankle sprains are categorized into three grades by clinicians:
- Grade I, which involves mild micro trauma to the ligaments;
- Grade II and Grade III involve partial or complete rupture of the ligaments that support the ankle.
With the exception of Grade I sprains, the ankle should be immobilized during the first 7-10 days of injury. Immobilization usually involves a walking boot although a fiberglass cast is also occasionally used. Rest, Ice, Compression, and Elevation are also appropriate during this time period (the acronym R.I.C.E will help you remember).
Immediately after the injury it is almost impossible to assess the damages to the ankle ligaments because the patient has too much pain to tolerate manipulation of the ankle. The first visit to your Podiatrist may also include x-rays to rule out fractures of the ankle or the foot. The ankle should be re-assessed 5 days after injury to allow for a thorough examination and to determine the full extend of ankle injury. Usually after day 10, the patient should be able to bear weight with the use of an ankle brace.
Although there is no consensus on the timing but early strengthening ankle exercises are important to prevent future injury or long term symptoms. This usually involves the use of a balance board and home exercises. This is best done under the guidance of a physical therapist. Many people who skip this step often end up with a condition known as chronic ankle instability and leaves them susceptible to repeat ankle sprains. This chronic ankle instability sometimes requires surgical repair of ruptured ligaments down the road. So if you or your child experiences an ankle sprain, skip the ER and call your Podiatrist to schedule a visit.
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