New York Orthopedic Specialist Discusses Ankle Sprains

Posted on: June 24, 2013

The Pain of Ankle Sprains

By – Dr. Kurt Voellmicke, Director of Foot and Ankle Surgery for the Orthopedic and Spine Institute, Northern Westchester Hospital.

foot-swarm As a doctor I find that it is common for many to be confused over what constitutes a sprained ankle.  What is a sprain, and what should you do if you have one? You’ll be happy to know that the answers are pretty straightforward.

The Definition

A sprain is defined as a stretched or torn ligament — the tough, fibrous tissue that connects one bone to another and supports your joints. By far the most common type of sprain is in the ankle.  Typically people roll their ankle outward and damage the ligaments on the outside of the ankle. Basketball and volleyball players are the most susceptible to sprains, followed by soccer and lacrosse players. Jumping and then landing unevenly or on the side of another player’s foot is the typical cause of a sprain.  Ankle sprains can also occur sliding into a base or running on an uneven surface. Having high arches can put you at higher risk of a sprain: The foot is like a tripod. The higher one’s arch, the more the tripod tends to tilt to the side.  Other risk factors include weakness of the supporting leg muscles or poor balance.

The Signs

While the intensity varies, pain, bruising, swelling, and inflammation are common to all three categories of sprains: mild, moderate, and severe, according to the American Academy of Orthopedic Surgeons.

What to Do

So your ankle is swollen and tender: When should you see a doctor? I always err on the side of caution. I think that all competitive athletes should be seen by an orthopedist after an ankle injury. The only question is whether you should go the same day or whether you can wait a day or two. My rule is if you can’t put weight on the joint, you should see a doctor immediately.

Be sure to practice RICE immediately: Rest, Ice, Compression, and Elevation. Sit or lie down, put your ankle up on some pillows, wrap it with an ace bandage, and ice it for 20 to 30 minutes several times a day.

After the ankle is evaluated and other injuries such as fractures or tendon injuries are ruled out, and depending on the severity of the sprain, you may be able to start rehabilitating your joint. With a severe sprain, I put a boot on the patient for two weeks or so.  As soon as possible, he likes patients to start strengthening the ankle through physical therapy.  One exercise patients can try is writing the alphabet with their big toe. Another is standing on one foot with your eyes closed; the goal is to work up to a minute. This improves your balance and strengthens the muscles that stabilize your joint.

Following through on rehab is key. The single highest risk factor for ankle sprain is having a history of sprain.  Completing an appropriate rehabilitation program and utilizing at least short-term bracing will decrease future risk of an ankle sprain.

 Prevention Tips

Reduce your risk of injury with these tips from the American Academy of Orthopedic Surgeons:

  • Participate in a conditioning program to build muscle strength
  • Do stretching exercises daily
  • Always wear properly fitting shoes
  • Nourish your muscles by eating a well-balanced diet
  • Warm up before any sports activity, including practice
  • Use or wear protective equipment appropriate for that sport