Posts for tag: Sprained Ankle

By Podiatry Associates of Indiana, P.C.
August 12, 2019
Category: Podiatry
Tags: Sprained Ankle  

Signs and Treatment for Sprained Ankles

Do you have a sprained ankle? Ankle sprains are among the most common injuries. Ankle sprains sprain occur when the ligaments in the ankle are stretched or torn. Ankle sprains can be very painful and incapacitating. If you have an ankle sprain, it's a good idea to see your podiatrist. Read on to to learn about the signs and treatment for sprained ankles.

Signs You Have a Sprained Ankle

1. Pain: An ankle sprain can be painful and can make it hard to carry out your day-to-day activities. You may also feel discomfort when you place weight on the affected area. The pain may worsen when the area is pressed and during standing or walking.

2. Redness: A sprained ankle can cause warmth and redness around the affected area. If your ankle is warm, red, and swollen, it is inflamed. Warmth and redness is caused by increased blood flow to the area.

3. Swelling: When an ankle is injured with a sprain, inflammation occurs. Swelling is the body’s protective response to an injury. Inflammation occurs because of increased fluid in the tissue. This is a normal reaction of the body and is the start of the healing process. However, sometimes the body produces more swelling that necessary.

4. Bruising: A sprained ankle causes bruising around the affected joint. A contusion, commonly known as a bruise, is made up of blood beneath the skin. A bruise results in a discoloration of the skin. Bruising is a result of injury to the blood vessels in the skin.

5. Stiffness: A sprained ankle causes limited range of motion and stiffness. Inflammation and pain often limit movement after the injury. Your podiatrist may advise against moving the ankle to allow your ankle to heal. Your podiatrist may also design an exercise program to reduce stiffness after the injury.

Treating a Sprained Ankle

1. Rest your ankle: All ankle sprains require a period of rest. Resting your ankle will allow the healing process to begin. Stay off your feet to allow your ankle to heal. Gently exercise your ankle on a regular basis to reduce stiffness. Avoid strenuous activites, such as running and aerobics, until you can walk without it causing any pain.

2. Elevate your ankle: Keep your ankle raised above the level of your chest for several days after injury. Use pillows to keep your foot elevated. Keep your foot elevated for a few hours per day until your ankle stops swelling. Elevation is important after an injury as it helps to reduce the amount of blood flow to the injured area. This helps to reduce the inflammation, bruising, and pain.

3. Ice your ankle: Ice treatment can help decrease pain, swelling, bruising, and muscle spasms. To make an ice pack, fill a freezer bag with ice. Put an ice pack on your injured ankle for 10 minutes every 2 hours. Wrap an elastic medical bandage around the ice pack to hold it in place. You should not use ice for more than 20 minutes at a time. If you have circulation issues or diabetes, talk to your doctor before applying ice.

4. Compress your ankle: Apply a compression bandage from the toes to above the ankle. Wrapping your ankle will help to avoid bruising and swelling. Wrap the bandage around your ankle and foot, and secure it with medical tape. Make sure the bandage doesn't restrict blood flow to your toes or make the pain worse. Do combine compression with elevationa and rest whenever possible.

5. Take a pain reliever: If you have severe pain, a narcotic pain reliever can make you feel better. An OTC pain reliever may also help reduce the pain and swelling. Most medical professionals recommend anti-inflammatory medicines such as naproxen, ibuprofen, or ketoprofen. You can also take acetaminophen for pain, although this medicine does not reduce inflammation. Be safe with medicines. Read and follow all instructions on the label.

6. See a doctor: A podiatrist can diagnose and treat an ankle sprain. Your doctor may order x-rays to determine if you have a broken bone in your ankle. You may receive an ankle brace to keep your ankle from moving and allow ligaments to heal. Your doctor will also give you medications to reduce swelling and pain. Once you can bear weight without increased pain, your doctor will add strengthening exercises to your treatment plan.

Whether your goal is getting back to work, hobbies, sports, the gym, or just enjoying life, a podiatrist can help. If you have an ankle sprain, search for a podiatrist in your area and schedule an appointment. A podiatrist can help you get back on track in no time!

By The Foot & Ankle Institute
December 18, 2018
Category: Foot Care
Tags: Sprained Ankle  

An ankle sprain occurs when the foot rolls or twists to the point where a ligament inside stretches beyond its normal capacity. Ankle sprains are extremely common, with an estimated 25,000 sprains happening in the United States every day. Athletes and people who work outdoors or on uneven surfaces are at a higher risk for spraining their ankle. Regular wear of high-heeled shoes is also a risk factor.

Sprained ankles are diagnosed by degree; that is, the severity of the sprain and the symptoms it produces. Grade 1 sprains are the mildest, with minimal swelling and tenderness due to a slight ligament tear. Usually, Grade 1 sprains still allow for weight to be put on the ankle. Grade 2 sprains have a more significant injury to the ligament and, while walking may still be possible, it is painful. Grade 3 sprains are diagnosed when the affected ligament has sustained a complete tear and the ankle cannot bear weight. Grade 3 sprains typically display obvious bruising and swelling around the ankle.

The grade of an ankle sprain will determine the treatment. The tried-and-true RICE method - rest, ice, compression, and elevation - is usually sufficient for Grade 1 sprains. Refraining from walking, keeping the ankle elevated for the first two days, stabilizing the ankle with a compression dressing, and applying ice to reduce swelling helps the sprain resolve within 2 to 4 weeks. Grade 2 sprains also respond well to RICE treatment, although healing typically takes longer and a firmer immobilization device, like a splint, is typically recommended. Grade 3 sprains often require similar treatment used for ankle fractures; a cast or brace may be needed and surgery may be considered for some patients.

To ensure proper healing, it is important to follow the recommendations of your podiatrist. Attempting to return to normal activity too soon could result in a repeat injury or permanent ankle instability.

Many of you may have suffered a broken ankle, ankle sprain or jammed your big toe in the past but are still suffering from constant aches and pains that often progress and worsen throughout the day. Many people seek medical attention for their post injury pain however if you are reading this you probably are postponing medical advice because “it will get better” or “I am too busy to see a doctor”. Unfortunately, the cause of the constant aches and pain may be related to the formation of post injury arthritis called post-traumatic arthritis.

Post traumatic arthritis is a condition that develops after an injury to any joint like your hip, knee and ankle. However, for a foot and ankle specialist the most commonly affected joint is the big toe joint and the ankle joint. As the severity of the arthritis progresses the integrity of the cartilage will become thin and wear away along the joint surface thus increasing the wear and tear of that joint and pain. Re- injury, mal-alignment of the joint, and increased body weight can also increase the wear and tear of the joint. The loss of cartilage within a joint will result in bone on bone contact causing symptoms of increased joint swelling, pain with activity that worsens throughout the day, and joint stiffness with reduced motion causing difficulty walking.

For an accurate diagnosis, the first step in treatment is an initial assessment by one of our foot and ankle podiatrists. A detailed lower extremity exam will determine which joints are affected, the type of motion present and the overall relationship of the foot to the ankle and leg. Standing x-rays are helpful to identify any structural changes within the joint space like joint space narrowing, formation of bone spurs and overall alignment of the entire foot. Depending on the severity of the arthritis and symptoms advanced imaging may be ordered for further evaluation.

Treatment for post- traumatic arthritis depends on the severity of the pain. Treatment options include non-surgical and advance to surgical options. Non-surgical conservative options include immobilization or support of the joints with the use of orthotics inserts or bracing, oral anti-inflammatory medications if you can take it and physical therapy to name a few. Arthritic joints can also be treated with injectable steroids in advanced cases. Conservative treatment will not cure the arthritis present however its aim is to reduce the pain and discomfort and increase the functional use of the joint. However, if you fail conservative treatment, then surgical treatment may be a viable option.

Surgical treatment is a more invasive way to remove, reshape and sometimes replace worn out joint surfaces. One example of ”cleaning out” a joint is with the use of Ankle Arthroscopy. This is a minimally invasive procedure that uses small incisions and a camera to look inside the joint. During arthroscopy inflamed tissue, loose bodies, and bone spurs can be removed. In more advance arthritic joints, the remainder of the joint surface is removed and is fused together in a more optimal position. Fusing a joint is not as scary as it sounds. The goal of a fusion is to eliminate the painful motion within a joint that no longer works correctly. Some patients may also be candidates for total ankle replacement that will maintain the motion and eliminate the pain.

The overall goal with any form of treatment is to decrease the amount of pain and discomfort present so that you can resume your normal active life with lasting relief. Unfortunately, there are no current therapies to prevent post-traumatic arthritis and it affects 5.6 million people in the United States. If you have pain or know someone who suffers with constant pain feel free to give us a call for future care and evaluation. We are only a phone call away.

By Dr. Tarick Abdo
January 31, 2013
Category: Sports Injury

While lateral ankle sprains are the most common athletic injury occurring in sports, high ankle sprains have been responsible for more lost time from game play and training activities. Unfortunately, high ankle sprains are commonly mistaken for lateral ankle sprains, thus they are less commonly reported. 

Misdiagnosing a high ankle sprain can result in lingering pain and recovery as the treatment course is much longer, requiring longer periods of offloading and rehabilitation in comparison to lateral ankle sprains. 

A high ankle sprain refers to injury of the ligaments that join the lower leg bones, tibia and fibula. High ankle sprain injuries commonly occur in collision sports, such as football, hockey, and court sports  such as basketball. The most common mechanism of injury is when the foot is anchored to the ground while being struck to the outside aspect of the lower leg. This forceful twisting injury may be accompanied by an audible pop and the patient’s inability to bear weight after the injury.  

On examination, patients often present with swelling and bruising above the ankle. The most commonly utilized test is the fibular squeeze test which can produce pain at the lower ankle by squeezing the outside and inside aspect of the leg at the middle of the leg.  In addition, your doctor can move the lower leg inward and this can elicit severe pain. At this stage, your doctor will order an x-ray the classic finding is widening of the tibia and fibula at the level of the ankle.  If the x-ray is inconclusive then a MRI scan provides the best confirmation of widening of the lower leg and identify specific syndesmotic ligaments that are disrupted. Treatment is then determined based on the degree of separation and the ligaments that are involved.

In some case where the degree of separation is severe usually greater than 4mm than surgical intervention is necessary to achieve anatomic reduction and can improve functional outcomes and facilitate a quicker return to activity. Without this intervention, patients can have long term pain and instability and develop post traumatic arthritis. Patients with less than 4mm of separation can be managed conservatively with immobilization for 1 week then placement in a double upright hinged ankle brace, known as a Velocity Brace this begins the next phase of rehabilitation. Then range of motion exercises are implemented with low intensity resistance and high repetition.  Gait training and light balance exercises may begin at the patient’s tolerance. The last phase of rehabilitation begins once a patient is able to hop on the injured foot without any pain. Patients then begin more active range of motion and change of direction exercises and can shortly return to full sports activity. 

The key to quick recovery from high ankle sprains is quick diagnosis by an experienced clinician. Then appropriate treatment based on the degree of instability. Most patients make a full recovery and have  no limitations once they return to activity. Hopefully this gives you some insight into this injury.    



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