When to worry about sprained ankle

Sports doctors note that ankle sprains are one of the most common injuries among track and field athletes [1]. However, people who are far from sports can also encounter it. Regardless of the conditions in which the ankle ligaments were damaged, it is important not to ignore the injury, but to take action in time and consult a doctor.

Injuries to one or more ligaments in the ankle joint area are commonly referred to as ankle sprains. More often, the injury affects the ligaments located on the outside of the joint, but the internal ones can also be damaged.

Classification of ankle sprains

There is no single classification of injuries to the ligamentous apparatus of the ankle joint; doctors use different options, for example, Anikin’s classification, which includes 3 degrees of damage, including ankle sprains:

• rupture of the capsule and rupture of the anterior talofibular ligament;
• partial rupture of the talofibular ligament and calcaneofibular ligament;
• complete rupture of two external ligaments

More often, practice is guided by  the recommendations of the American Medical Association [2].

Causes of ankle sprains

“Damage to the ankle ligaments can be caused by various reasons: an unsuccessful fall, jumping, twisting of the foot. These are situations when external rotation and/or dorsiflexion of the ankle joint occurs,” explains Evgeniy Chekan.

Among the most common reasons:

• a fall resulting in a twisted ankle;
• awkward landing on your foot after a jump or turn;
• walking or exercising on uneven surfaces;
• direct injury with an object or blow to the ankle joint.

Symptoms of a Sprain

The signs of a sprained ankle are fairly typical, but they can manifest in different ways. It depends on how severe the injury is. Patients complain about:

• pain, especially when walking and touching;
• swelling or swelling;
• the appearance of hematomas;
• limitation of range of motion in the joint;
• instability of the ankle joint.
• sensation of a clicking or sound at the time of injury.

What happens to the ankle when injured?

Any damage to the ankle ligaments affects muscle fibers, blood vessels, and nerve cells. The severity of symptoms and severity of consequences depend on how serious the ligament damage is. They may be minimal or cause significant discomfort.

Soon after the injury, processes begin to occur sequentially that help restore the integrity and functionality of the ligaments. However, if the damage is severe, it may be difficult or even impossible to fully restore function to the elastic ligaments.

1. Inflammation

Immediately after the injury, typical symptoms appear: swelling, pain, limited mobility, which is typical for the inflammatory stage, which lasts up to two weeks.

2. Recovery

During this period, which takes 1-3 months, there is increased work of fibroblasts, cells that produce collagen, which forms the basis of ligaments.

3. Perestroika

The final stage of healing of sprains takes several months. During this time, the symptoms become less pronounced, and the ligaments become stronger and more elastic.

First aid for a sprained ankle

A sprained ankle may seem like a minor injury compared to fractures or other injuries, but it should not be ignored. It is important to contact a specialist as soon as possible – you can get to the doctor or emergency room on your own, or, if this is not possible, you should call an ambulance.

Before the patient is examined by a specialist, the following algorithm must be followed:

• limit movement – stop training, walking, running and other activities;
• take off your shoes;
• secure the ankle joint with a tight bandage – an elastic bandage will do;
• Apply cold to the injury site.

Treatment of severe ankle sprains

Treatment for a sprained ankle should be prescribed by a doctor. Tactics depend on the nature of the damage and the characteristics of the patient.

1. Anti-inflammatory ointments

Nonsteroidal anti-inflammatory drugs (NSAIDs) as well as anti-inflammatory ointments may be recommended to reduce pain and inflammation.

2. Elastic bandage or taping

A bandage, taping , or brace may be used to control swelling and limit movement. You can’t do without a doctor here.

3. Compress

“Apply an ice pack to the injured area (be sure to wrap the ice in a cloth such as a towel). Use ice for 20 minutes, and then wait at least 40 minutes before applying ice again,” advises Evgeniy Chekan.

4. Rest

Limit, or better yet eliminate, the load on the injured limb. Walking can cause further injury.

5. Elevated limb position

The ankle should be elevated slightly above the level of the heart to reduce swelling.

6. Early physical therapy or shock wave therapy

These therapies are necessary to speed up healing and reduce the recovery period.

Diagnosis of ankle sprain

It is not always possible to independently diagnose a sprained ankle; you cannot do without visiting a doctor. He can either confirm or refute the diagnosis. What is usually included in the diagnosis:

• taking anamnesis by a doctor;
• physical examination;
• MRI and ultrasound of soft tissues in the damaged area, which are needed to see a partial or complete rupture of the ligamentous apparatus [3];
• X-ray examination of the joint, necessary to exclude a possible fracture of the ankles or talus.

Which doctor should I contact if I suspect a sprained ankle?

“If the soft tissues of the ankle joint are damaged, you must contact an orthopedic traumatologist. The specialist will carefully collect anamnesis, ask about the circumstances of the injury, and conduct a physical examination,” says Evgeniy Chekan.

Preventive measures for ankle sprains

There are several tips that you can follow to reduce your risk of this common injury.

• Engage in sports and ankle strengthening exercises.
• Always warm up before training, even if the load seems light.
• Use the right shoes for sports, choose stable models with ankle support.
• Be alert and remove any obstacles or possible hazards in your home, yard, or playing field.
• You can use orthoses or bandages to stabilize the ankle joint – this is important for those who have already encountered such an injury.

Reviews and recommendations from a traumatologist

“If you suspect you may have suffered a sprain, take first aid measures: limit your mobility, apply ice or even a package of frozen vegetables wrapped in a towel, and then be sure to see a doctor to get timely help and prevent more serious injuries,” reminds doctor Evgeniy Chekan.

It is not recommended to put stress on the ankle joint; rubbing, taking a hot shower or bath is not recommended.

If the doctor has already examined the injury site and prescribed treatment, it is important to follow all recommendations and not remove the fixing bandages without the advice of a specialist.

Memo to the victim: what to do if you sprain your ankle

The most important thing to do if you feel sharp pain is to stop any activity.

1. Do not move the limb.
2. Remove shoes and socks that may put pressure on the injury site.
3. Apply cold (this is effective only in the first day after the injury).
4. Take painkillers.
5. Go to the doctor