What is a sprained ankle and how to treat it.

A sprained ankle is a very common type of ankle injury. A sprain is stretching and or tearing of ligaments. (You sprain a ligament and strain a muscle). The most common damage done in an sprained ankle is to the talo-fibula ligament towards the front. If the sprain is worse there might also damage to the calcanao-fibula ligament which is further back towards the back of the heel. In addition to the ligament damage there may also be damage to tendons, bone and other joint tissues.

A sprained ankle is classified into three categories depending on severity:

First degree ankle sprain :

Some stretching or perhaps tearing of the lateral ankle ligaments.
Little or no joint instability.
Mild pain
Little or no swelling
Some joint stiffness or difficulty walking or running.

Second degree ankle sprain:

Some tearing of the ligament fibres.
Moderate instability of the joint.
Moderate to severe pain and difficulty walking.
Swelling and stiffness in the ankle joint.

Third degree:

Total rupture of a ligament.
Gross instability of the joint.
Severe pain initially followed by no pain
Severe swelling
What can the athlete do for a sprained ankle?

Treatment of a sprained ankle can be separated into immediate first aid and longer term rehabilitation and strengthening.

Immediate First Aid for Ankle Sprains:

Aim to reduce the swelling by DR .ICE. (Diagnosis Rest, Ice, Compression, Elevation) as soon as possible. Getting the diagnosis right from the start is important.

D is for diagnosis. It is important to get the correct diagnosis from the start. If other factors such as an avulsion sprain (where a bone fragment is pulled away from the bone) are suspected then treatment may be different.

R is for rest. It is important to rest the injury to reduce pain and prevent further damage. If you need crutches then use them! People with crutches get more sympathy! Many therapists advocate partial weight bearing as soon as pain will allow. This is thought to accelerate rehabilitation.

I is for ICE or cold therapy. Applying ice and compression can ease the pain, reduce swelling, reduce bleeding (initially) and encourage blood flow (when used later).

C is for compression - This reduces bleeding and helps reduce swelling.

E is for Elevation - Uses gravity to reduce bleeding and reduces swelling by allowing fluids to flow away from the site of injury. So put your feet up and get someone else to wait on you.
In addition to immediate first aid the athlete can do the following:
Protect the injured ankle by taping or a support. Tape can also be used during the rehabilitation phase to protect the joint and give proprioceptive feedback to the ankle without risking further injury. When partial weight bearing an ankle support or taping method can protect the lateral ligaments (allowing them to rest) while ensuring forwards and backwards motion is allowed keeping the rest of the joint healthy.
What can a sports injury specialist do about it?

A sports injury specialist can make a diagnosis of the injury so time is not wasted treating the wrong condition.
A doctor may prescribe anti inflammatory medication to help with pain and swelling.
Reduce swelling by compression devices or taping techniques.
Use ultra sound and laser treatment.
Use cross friction massage.
Prescribe a full ankle rehabilitation programme.
More detailed information on assessment, rehabilitation, stretching, strengthening and sports massage is available to subscribers including:

Assessment

Observations
Active movements
Passive movements
Resisted movements
Functional assessment
Palpation
Rehabilitation

Aims of rehabilitation

Phase 1 - Immediate first aid
Phase 2 - rehabilitation
Phase 3 - Returning to full fitness
Preventing ankle injuries
Stretching and mobility

Treatment includes

Suporting or bracing the ankle
Manual joint mobilization
Balance board mobility
Ankle mobility exercises
Lower leg and ankle stretches
Strapping and taping

Louisiana wrap strapping
Basketweave taping
Quick support taping
Strengthening

Static exercises
Dynamic exercises
Sports Massage

Cross friction massage

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