Sprained Ankle

A sprained ankle is often caused by twisting your foot, which makes the ligaments of your ankle stretched over their normal range:

• A fall that causes your ankle to twist
• Walking on irregular surfaces
• Losing your balance with your high heels
• Previous ankle sprain which have already weakened your ligaments
• Participating in sports that require a lot of rolling and twisting, such as basketball, tennis, football, etc., which makes you vulnerable to sprain your ankle

In most of the sprained ankle cases, you will most likely feel the pain right away after twisted. Symptoms include:

• Pain
• Tender to touch
• Swelling
• Bruising
• Difficult to move

Sometimes you will have extreme pain at first, and will not be able to move or put weight on your foot. Usually the more pain you have, the more severe your situation is, and the longer it takes to heal.

In case your situation is mild, which means you can move with your injured foot, your doctor will do a physical examination for assessment. He or she will check for points of tenderness at your foot; moving your foot in various ways to check the range of motion.
 

If your situation is severe, the following imaging tests may be needed to check if your bone is broken or tissues are damaged:

• X-ray
  X-ray is often a good way to check your bones, but is less effective in visualizing soft tissues. Tiny cracks may not show up in an early x-ray check as well.
• Bone scan
  A small amount of radioactive substance will be injected to an intravenous line. Damaged areas will show up as bright spots that it is good to detect stress fractures.

• Computerized tomography (CT) scans
  CT scans take x-rays from different angles for a detailed look at the bones of the joint and internal structures.
• Magnetic resonance imaging (MRI)
  MRI uses radio waves and magnetic field to produce detailed outlook of the internal structure and soft tissue damages.

Self-help rules:

After you have sprained your ankle, you should treat it as soon as possible to speed up recovery. There are some self-help rules namely PRICE and HARM include:

• PRICE procedure for protection
  • Protect you from any further injury
  • Rest for two to three days
  • Ice the injured area by using an ice pack
  • Compress the area by bandage to support and help reduce swelling
  • Elevate the injured area above the level of your heart to control swelling
• HARM procedure to avoid further harm
  • Heat: Do not use heat packs which may encourage blood to flow to the area
  • Alcohol: Do not drink alcohol as it increases bleeding and swelling
  • Running or any form of strenuous exercises should be avoided
  • Massage: Do not massage as it increases bleeding and swelling
     

Physiotherapy

When you are able to move better without pain, your doctor or physiotherapist may tailor some exercises for you to strengthen the muscles around your ankle. Physiotherapy is often done for recovery purpose. It restores your range of movement, strength and balance with the following techniques:

• Massage
• Ultrasound
• Exercises
• Taping or having a brace placed around your ankle
• Balance and stability training such as standing on one leg

Surgical management:

A sprained ankle rarely needs a surgery to heal. However if your ankle is causing you persistent pain after all kinds of basic treatments, you may be referred to an orthopaedic surgeon for further check-up. Sometimes a surgery may be needed to repair a severely torn ligament. Surgical options include:

• Arthroscopy
  An arthroscope is used to look inside the joint to see if there are any loose fragments of bone or cartilage that caught in the joint.
• Reconstruction
  A torn ligament will be repaired with stitches or suture, or using other ligaments in the feet to repair the damaged ligaments.
   

Rehabilitation Management:

It depends on the severity of your condition and the types of surgery that you have done. Rehabilitation often involves time to restore the pre-injury function. It may range from weeks to months. A series of physiotherapy sessions may promote speedy recovery.

Indeed it is almost not possible to avoid it as it can be caused by an accident. However, it is most important to maintain the strength, flexibility and balance of the muscles around your ankle:

• Wear a well-fitted shoes which are appropriate for the activity that you are going to do
• Be extra careful if you are on high-heeled shoes
• Wearing a semi-rigid ankle brace has been shown as an effective way of prevention.