Ankle Sprains are one of the most common musculoskeletal problem effecting all ages and people of all different activity levels. There are different locations and several different grades depending on severity, with the high and low lateral ankle sprains being the most common.
We have probably all felt the immediate pain of a “twisted” ankle. Sometimes it subsides, and there is not much bruising or swelling and walking is fine in a few days. Other times, your ankle might turn all kinds of interesting colors and swell up more than you ever thought possible. In more severe cases, weight bearing is not possible, and you are in for a long haul of surgery and rehab.
But even the mildest of sprains can leave you feeling “stiff” with a some loss of range of motion at the ankle joint that can have lasting effects not only for your ankle, but have a domino effect all the way up your leg to your pelvis. Once walking is compromised, you begin to lose calf musculature and become less efficient. Eventually you can even start to have pelvic alignment issues and muscle inhibition. Severe grade 2 and 3 cases can cause chronic pain, stiffness and proprioceptive issues if left untreated, as often the effect of immobilization are almost as bad as the injury.
So the next time you “twist” your ankle, do yourself a favor and seek medical advice from your doctor and physical therapist to make sure you don’t have any last effects. To get on my soap box, the RICE principle has been proven to prevent healing and icing is best only if you want to reduce pain. The British Journal of Sports Medicine, for example, investigated 22 separate studies and concluded that “ice is commonly used after acute muscle strains, but there are no clinical studies of its effectiveness.” A report in the Journal of Strength and Conditioning Research was even more alarming. Not only does icing fail to help injuries heal, the authors found, it may well delay recovery from injury. Think “ARITA” …Active Recovery Is The Answer. More on that later!
So for acute injuries…avoid ice and NSAIDS and let the body go through the healing stages. Your body is much smarter than you are. Compression and warm baths are best, with some active movement around the compromised area to enhance the lymphatic drainage system.
Grades of ankle sprain severity
|Severity||Damage to ligaments||Symptoms||Recovery time|
|Grade 1||Minimal stretching, no tearing||Mild pain, swelling, and tenderness. Usually no bruising. No joint instability. No difficulty bearing weight.||1–3 weeks|
|Grade 2||Partial tear||Moderate pain, swelling, and tenderness. Possible bruising. Mild to moderate joint instability. Some loss of range of motion and function. Pain with weight bearing and walking.||3–6 weeks|
|Grade 3||Full tear or rupture||Severe pain, swelling, tenderness, and bruising. Considerable instability and loss of function and range of motion. Unable to bear weight or walk.||Several months|
|Source: Adapted from Maughan KL, “Ankle Sprain,” UpToDate, version 14.3, and Ivins D, “Acute Ankle Sprain: An Update,” American Family Physician (Nov. 15, 2006), Vol. 74, No. 10, pp. 1714–20.|
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