The reason I have the blues is because I cannot run, and have not run in 5 weeks. I have a Grade II inversion and eversion ankle sprain. I followed the doctor’s orders and iced, wore the brace for 3 weeks, and took 800mg of ibuprofen for 3 weeks, three times per day. Unfortunately, I am still not able to run on it. I missed 4 races that I signed up for during the month of August. I have just been able to walk normally on it without a brace this week. Surprisingly, there is still some slight swelling, but there is no longer any bruising or discoloration on either side of the ankle anymore. This ordeal has completely thrown me for a loop, put a dent into my end of summer and fall running plans and given me the blues……
A sprained ankle occurs following a sudden sideways or twisting movement of the foot. All it takes is an awkward step or an uneven surface to cause an ankle sprain–that is why sprained ankles are among the most common orthopedic injuries. Orthopedic doctors see patients for ankle sprains very often, and it is the most common foot and ankle injury.
How does an ankle sprain occur?
A sprained ankle usually occurs when a person lands from jumping or running on to an uneven surface. For example, sprained ankles are often seen when basketball players come down from a jump and land on another player’s foot. Ankle sprains also occur with more routine daily activities such as stepping off a curb or slipping on ice.What happens inside the ankle when it is sprained?
An ankle sprain is an injury to the ligament in the ankle. The ligaments are structures that control excessive movement of the joint. When an ankle sprain happens, the ligament is stretched too far, and is either partially or completely torn.There are two broad categories of ankle sprain:
The most common type of ankle sprain occurs when the foot is inverted, falling inward. When this type of ankle sprain happens, the outer, or lateral, ligaments are stretched too far. There are three ligaments that attach to the outer side of the ankle. About 90% of ankle sprains are inversion injuries. Pain is always on the outside of the ankle, and there is usually no pain on the inside of the ankle joint. Eversion Ankle Sprains
The other type of sprained ankle is called an eversion injury, where the foot is twisted outwards. When this occurs, the inner ligament, called the deltoid ligament, is stretched too far. Patients will have pain on the inner side of the ankle.
Common symptoms associated with an ankle sprain are pain with swelling and bruising. The degree of symptoms tends to correlate well with the extent of the damage to these ligaments.
- Grade I Ankle Sprain:
Grade I ankle sprains cause stretching of the ligament. The symptoms tend to be limited to pain and swelling. Most patients can walk without crutches, but may not be able to jog or jump. - Grade II Ankle Sprain:
A grade II ankle sprain is more severe partial tearing of the ligament. There is usually more significant swelling and bruising caused by bleeding under the skin. Patients usually have pain with walking, but can take a few steps. - Grade III Ankle Sprain:
Grade III ankle sprains are complete tears of the ligaments. The ankle is usually quite painful, and walking can be difficult. Patients may complain of instability, or a giving-way sensation in the ankle joint.
As said before, pain and swelling are the most common symptoms of an ankle sprain. Patients often notice bruising over the area of injury. This bruising will move down the foot towards the toes in the days after the ankle sprain–the reason for this is gravity pulling the blood downwards in the foot.Do I need to see the doctor if I have an ankle sprain?
If you do have significant symptoms following a sprained ankle, you should seek medical attention. Signs that should raise concern include:
- Inability to walk on the ankle
- Significant swelling
- Symptoms that do not improve quickly or persist beyond a few days
- Pain in the foot or above the ankle
Differentiating between a sprained ankle and an ankle fracture can be difficult, and sometimes an x-ray is needed. While moderate pain and swelling are common symptoms following a simple sprained ankle, symptoms such as inability to place weight on the leg, numbness of the toes, or pain that is difficult to manage should raise concern. If you think you may have done more than sustained a sprained ankle, you should seek medical attention.What is the treatment of a sprained ankle?
Treatment of sprained ankles is important because returning to normal activities in a timely manner is important for most patients.
The early treatment of a ankle sprain is the “RICE” method of treatment. If you are unsure of the severity of your ankle sprain, talk to your doctor before beginning any treatment or rehab. The following is an explanation of the RICE method of treatment for ankle sprains:
- Rest:
The first 24-48 hours after the injury is considered a critical treatment period and activities need to be curtailed. Gradually put as much weight on the involved ankle as tolerated and discontinue crutch use when you can walk with a normal gait (with minimal to no pain or limp). - Ice:
For the first 48 hours post-injury, ice pack and elevate the ankle sprain 20 minutes at a time every 3-4 hours. The ice pack can be a bag of frozen vegetables (peas or corn), allowing you to be able to re-use the bag. Another popular treatment method is to fill paper cups with water then freeze the cup. Use the frozen cube like an ice cream cone, peeling away paper as the ice melts. Do NOT ice a ankle sprain for more than 20 minutes at a time!! You will not be helping heal the ankle sprain any faster, and you can cause damage to the tissues! - Compression:
Use compression when elevating the ankle sprain in early treatment. Using an Ace bandage, wrap the ankle from the toes all the way up to the top of the calf muscle, overlapping the elastic wrap by one-half of the width of the wrap. The wrap should be snug, but not cutting off circulation to the foot and ankle. So, if your foot becomes cold, blue, or falls asleep, re-wrap! - Elevate:
Keep your ankle sprain higher than your heart as often as possible. Elevate at night by placing books under the foot of your mattresses–just stand up slowly in the morning.
More severe ankle sprain injuries, including complete tears of the ligaments and fractures of the bone may need different treatment and rehab than a simple ankle sprain. It is important that you see your doctor before beginning treatment or if your symptoms do not steadily improve over time.
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