Ankle Sprain II
Ankle sprains and ligaments of the ankle joint.
Ankle sprains are among the most common sporting injuries that occur during a variety of activities. Spraining refers to wrenching or twisting a ligament aggressively which can lead to swelling, pain and decreased range of motion. To thoroughly understand the mechanism of injury we must first understand the structures that provide stability and structural support to the ankle joint. Ligaments are fibrous connective tissue that connect two or more bones together between a joint space. Ligaments act as protective structures that create structural boundaries to the natural movement of joints. There are two major sets of ligaments surrounding the ankle joint; these are the medial collateral ligaments AKA deltoid ligament and the lateral collateral ligaments. The deltoid ligament complex are those found in the interior portion of the ankle or the medial side, they are composed of the following ligaments: Posterior and anterior tibiofibular ligaments, tibiocalcaneal and tibionavicular ligaments. The deltoid ligament collectively is considered the strongest ligament of the ankle joint providing the most solid structural integrity to the interior portion of the ankle joint. The lateral ligament is the most commonly sprained ligament of the ankle joint, specifically the anterior talofibular ligament. Torsional, or excessive rotational movements, ankle rolling outward damages the lateral ligaments causing swelling, redness and decreased movement; symptoms arise almost immediately.
How are ankle sprains diagnosed?
The patient may be able to walk with decreased range of motion, but will complain of excessive pain and tenderness especially when touched. Obtaining a good history of the injury as well as X-ray imaging of the ankle can provide evidence as to whether there is also a bony injury in conjunction with the sprain. Your doctor may perform a few tests to check for stability of the ankle joint. In more severe cases, an MRI may be needed to rule out other injuries.
How are ankle sprains treated?
The primary treatment is the RICE approach which stands for: Rest, Ice, Compression and Elevation.
Non-steroidal Anti-inflammatory medication such as Ibuprofen. During the first 24-48 hours using ice packs intermittently can decrease the swelling in the area surrounding the sprain. An ACE wrap should be used to keep compression over the ankle joint to reduce the swelling, it is important to note that ace wraps do not provide rigid structural integrity the way a cast or walking boot does, and therefore weight bearing should still be limited. Elevation above the level of the heart for 3 hours a day will also help diminish swelling in the area. In some cases Crutches may be used until weight bearing does not produce pain. Physical therapy is vital to strengthening the surrounding muscles in the area.
Returning to sports or regular activities.
After proper rehabilitation, wearing an ankle brace during weight training or exercise can help preserve the structural integrity of the ankle. Typically, once an ankle is sprained it is subject to re-spraining, wearing shoes with lateral support can also help prevent injury. If for some reason pain persists after rehabilitation, a physician may order an MRI and perhaps surgical treatment.
For more information visit us at www.texasfootdoctor.org
For an appointment call us at (817) 424-FOOT (3668).