Ankle Sprains, Boy Can They Hurt!

Injuries to the ankle are very common especially among highly active individuals but it can happen to anyone. Even simple day to day activities can cause an ankle sprain if too much unexpected force is applied to the foot. Patients often recall taking a wrong a step off a curb and feeling a "pop." One patient said he ran after the mailman and actually heard a "pop" from his leg. So what could that "pop" be? 

The ankle joint consists of three important bones, tibia, fibula, and talus, held together by ligaments. The common "popping" sound comes from tearing any one of these ligaments, most commonly the anterior talofibular ligament. This ligament is located on the outside ankle towards the front of the foot. Sometimes, this injury is overlooked because people are still able to walk on it. Some swelling, bruising, and pain may be noted at the ankle and are key indicators of an underlying injury. 

It is important to know when this type of injury requires medical attention. For the most part, common ankle sprains can be alleviated by the acronym "RICE." Resting the injured foot by limiting motion until the swelling goes down; icing the area with a bag of frozen vegetables or ice pack, compression such as a fabric bandage wrapped around the ankle, and elevating the foot will help the swelling to go down too. Taking over the counter pain medicines should help with some of the discomfort. 

However, if there is a break in the skin and bone appears to be protruding through the skin, or new bumps appear in the skin, seek care immediately. Other signs that require emergent care includes the inability to walk a few steps, unbearable pain, and if the color of your foot turns dusky and pale. These may be signs that a bone has been broken and healing prognosis is better with early detection. 

If in doubt, seek professional advice from your podiatrist. They may want you to come into the office and run additional tests if necessary. Some tests they may order includes evaluating that the nerves and arteries are in-tact, x-rays to see if bones are injured, ultrasonography to evaluate the ligaments, and sometimes CT scans. The physician may also order crutches and/or apply a brace to help your ankle heal properly. 

There are many things you can do to prevent future injuries. Strengthening exercises can be recommended by a physical therapist. Proper shoes that provide ankle stability are helpful, such as high top tennis shoes. However, high heeled shoes actually put the ankle in an unstable position so are best avoided to avoid ankle injuries. 

Surgery is uncommon for this type of injury but may be indicated if the ankle does not heal with conservative treatment. Good news is that the majority of ankle sprains will not require any surgery and will benefit with strengthening exercises to prevent future injuries. These preventive measures can be discussed with your podiatrist. 

Dr. Harvey Danciger
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Dr. Harvey Danciger is a podiatrist and foot surgeon in Palm Desert, CA specializing in the foot and ankle
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