Patients often present for an initial consultation complaining of a swollen, painful ankle for several weeks to months. When I ask them why they took so long to come into the office for this condition, one of the most common responses is "it was just an ankle sprain."

Even though ankle sprains are common, they are not always minor injuries. Some people with repeated or severe sprains can develop long-term joint pain and weakness. Treating a sprained ankle right away can help prevent ongoing ankle problems.

Many people believe that an ankle sprain is nothing serious and that it will resolve on its own, but there are many reasons why this is not an assumption any of us should make.

First, immediate treatment of ankle sprains is vital to having a speedy recovery. The sooner that treatment is initiated, the sooner the patient will be back to walking pain-free, working, wearing normal shoe gear, and exercising. Even in the mildest forms of ankle sprains, immediate RICE (rest, ice, compression, and elevation) treatment is necessary to prevent swelling and pain.

Next, the severity of the injury must be evaluated before treatment is rendered. There are different grades of ankle sprains, ranging from mild to severe, depending on how badly the ligament is damaged and how many ligaments are injured. With a mild sprain, the ankle may be tender, swollen, and stiff. It may feels stable, and walking may be pain-free or slightly uncomfortable. A more severe sprain has bruising and tenderness around the ankle, and walking is much more painful. In a severe ankle sprain, the ankle is unstable and may feel "wobbly." In more severe sprains, a pop or snap may be heard while something tears. There will be extreme pain at first and walking as well as weight bearing will not be possible. Usually, the more pain and swelling present, the more severe the ankle sprain is and the longer it takes to heal. This is not always the case, so it is important to have all ankle sprains evaluated as soon as possible.

There are also many "hidden" injuries associated with ankle sprains that may not be evident without a clinical examination and x-rays, such as ankle fractures, foot fractures (of the fifth metatarsal base, talar dome, talus, or calcaneus), muscle tears of the foot or leg, injuries of the Achilles tendon, dislocations of the peroneal tendons, and more. In children, there could also be an injury to the growth plate of the lower leg.

Proper treatment and rehabilitation exercises are very important. If an ankle sprain does not heal correctly, the joint may become unstable and may develop chronic pain. This can cause ankle weakness which leads to a higher chance of re-injury. Taping the ankle or wearing a brace during exercising can help protect the ankle joint. Wearing proper shoes and orthotics for support also help.

In more severe cases, if the ankle is still unstable after rehabiliation, or if the ligament damage is severe, the doctor may recommend surgery to repair the torn ligaments.


Copyright (c) 2009 Michele Colon