CONDITION - Acute Ankle Sprain
The word acute usually means within the past six (6) weeks. This is the most common injury of the foot and ankle and almost 25,000 people sprain their ankle each day. The most common way people sprain their ankle is by turning the ankle inward, which is called supination or inversion by your doctor. When your ankle turns in, you put strain on the outside (lateral) aspect of your ankle which most commonly sprains the ligaments holding your outside bone (fibula) to your ankle bone (talus) or to your heel bone (calcaneus).
The ligament most commonly torn by an ankle sprain is called the anterior talo-fibular ligament, or ATFL for short. Sometimes with severe sprains, the ligament on the inside of your ankle, called the deltoid ligament can be torn. "High ankle sprains" are the most severe types of sprains involving the ligament that connects the tibia and fibula together; the syndesmosis.
Your doctor will typically grade the sprain based on severity of the ligament injury. Grade 1 is a simple stretch of the ligament. Grade 2 involves a partial tear. Grade 3 involves a complete tear.
Luckily, most sprains heal easily with simple treatment.
Most orthopedic surgeons agree that acute ankle sprains should first be treated conservatively. This means without surgery. However, each person is different and your doctor may feel you need surgical treatment immediately. If you are told that you will require conservative care you can remember the plan easily by remembering the words: Control, Avoid, and Rehabilitate.
Control: Get your pain under control
The easiest way to remember this is: R.I.C.E. Each of these letters stands for:
- Rest. Rest your ankle. Do not place weight on it if it is very tender. Avoid walking long distances.
- Ice. Ice helps to decrease pain and swelling. Ice therapy is also known as cryotherapy or cold therapy. Do not apply ice directly to your skin for more than five (5) minutes as it can cause burns. A device specially designed to cool your foot, ankle and heel (see our PolarCare Cub) can be used for longer periods, as long as you carefully follow the directions and discontinue its use if you have pain or a burning sensation.
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Compression. Compression involves using a wrap of some sort to help manually squeeze out the fluid from your ankle; this helps relieve pain and improve function. Our Ankle Sprain Care Kit includes two devices that help provide compression:
- A compressive dressing that you apply around your ankle, and
- An ankle brace that not only provides you with ankle stability, but also helps to "milk" the fluid out of your ankle as you walk.
- Elevation. Elevate the ankle above the level of your heart to help reduce the fluid in the ankle after a sprain.
Other ways to control your pain include:
Over-the-counter pain medications can be of use. Acetaminophen (TylenolTM) can provide optimal pain relief with limited side effects. Anti-inflammatories such as MotrinTM (ibuprofen) and AleveTM (naproxen) may also be beneficial, however, do not take pain medications for a prolonged period of time without consulting your physician. Occasionally, your physician may prescribe prescription medications such as anti-inflammatories or narcotics. However, their use should be limited to only a short period of time.
Braces provide pain relief by stimulating your nerve fibers which make you feel that your foot is more stable and secure. In addition to providing stability, an ankle brace compresses your surrounding tissue making it actually feel better. This is what occurs when you strike your thumb with a hammer. Even though you just crushed your thumb, you grab it and squeeze it hard. This compresses the nerve fibers making it feel better. An ankle brace works somewhat on the same principle. Our custom Ankle Sprain Care Kit provides you with the best ankle brace in the industry and everything you need to recover from an ankle sprain including an ice pack, compressive wrap, exercise band, exercise video and easy to follow instruction booklet. This brace by AirCast™ is considered the best in the industry because it provides comfort and compression as it gently milks fluid out of your ankle with each step. The anatomically contoured design provides optimal support while allowing controlled motions of your ankle. Our Ascend Stabilizer Brace is useful for people who have recovered from their sprain, are returning to sports, hiking, or extended walking, and require some added stability to prevent further sprains.
Avoid activities that cause your pain
Just like the old bad joke about the patient that told the doctor, "Doc, everytime I do this, my knee hurts" and the doctor replies, "Well, don't do that!" Although this may seem humorous, there is some truth to the joke. Avoid such activities as squatting, kneeling, heavy lifting, climbing, and even running. Listen to your body and make a list of activities or movements that increase your pain and DON'T DO THESE THINGS. Also, make a list of activities and movements that reduce your pain and DO THESE THINGS. For example, many doctors recommend the following (be sure to check with yours to make sure he/she agrees).
DON'T DO these if you have an ankle sprain:
- Avoid walking with poorly designed shoes (see our arthritis section for more information on proper shoes).
- Avoid walking on uneven surfaces such as beaches, trails and lawns.
- Avoid using the stairs, ladders, or any unprotected heights where you must balance yourself on one foot.
- Avoid allowing your ankle to hang down below your knee as this may increase swelling and pain.
DO these if you are recovering from a sprain:
- Keep your ankle elevated above your heart level.For example, lie on your back and elevate your ankle on a few pillows to keep it above your heart.
- Keep your ankle stable with an ace wrap, stabilizer brace, or our AirCast™ Ankle Sprain Care Kit.
- Keep your ankle cool with an ice bag or frozen vegetables (peas work best) to reduce swelling.
- After your swelling is reduced, do the exercises instructed by your physician or therapist to help regain the motion of your ankle. Sample exercises, including a video, are provided with our Ankle Sprain Care Kit.
- Wear proper fitting, well-constructed shoes (see our arthritis section for more information on proper shoe wear).
- Have a positive attitude. Remember that most people with acute ankle pain recover within 2-6 weeks.
Rehabilitate your ankle
The key to this step is to remember controlled motions. This means you have complete control of these motions through a structured rehabilitation program. Most rehabilitation programs can be done in the convenience and privacy of your own home. The basic philosophy of rehabilitation for a simple ankle sprain is to strengthen and gently stretch the muscles around your ankle to help support the injured or strained muscles, tendons or ligaments. This may include stretching your heel cord and gently moving your ankles in and out to expedite the healing of your ankle ligaments. Remember that keeping your ligaments absolutely still for a prolonged period of time will actually starve your ligaments of the nutrition they need to repair themselves. In specific cases, your doctor may prescribe formalized physical therapy, with a therapist or trainer. The keys to rehabilitation include:
- Motivation to actually do the exercises. See our page on motivational strategies to improve your success.
- Correct exercises for your problem. See your doctor or physical therapist if you need advice in this regard. With the purchase of our AirCast™ Ankle Sprain Care Kit you will receive a set of easy to follow ankle exercises along with videotape to show you the correct sequence and technique.
- Proper equipment. This equipment can either be at your therapist's office; at your health club; or items that you purchase for use at home. We have found that people who do their exercises at home are much more likely to benefit from the program as they more frequently perform the exercises. The AirCast™ Ankle Sprain Care Kit provides you with a Theraband™ progressive resistance elastic tube, which will allow you to add strength training to your recovery program.
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