Treatment Options For A Sprained Ankle: Physical Therapy and Bracing Matter.

Ankle sprains are the most common athletic injury and also the most common orthopedic problem presenting to emergency rooms. What is interesting is that only a small portion of ankle sprains actually go to the emergency room and most are treated at home. Treating an ankle sprain is far more complicated than is given credit.  Since ankle sprains are so common, they are often under treated or not treated at all.  It is important to consider that an ankle sprain is a partial dislocation of the ankle joint with all the associated complications.  

Sprained Ankle Presenting Symptoms:

• Swelling of the ankle
• Pain along the arch or outside tendons of the ankle 
• A feeling of the ankle being loose
• Cracking in the ankle
• Tingling around the ankle

It is essential to take care an ankle sprain aggressively and to make sure that the ankle sprain is only a sprain and not a tendon tear or cartilage damage.  I highly recommend scheduling an appointment to see a doctor within a day or two to check ankle and take x-rays to make sure there is no major ankle for foot damage.

Common Injuries Associated with a Sprained Ankle:

• Peroneal tendon tear
• Posterior tibial tendon tear
• Osteochondral lesion of talus (cartilage damage)
• Loose bone in ankle
• Ligament tear
• Syndesmosis injury
• 5th metatarsal foot fracture
• Lisfranc Fracture Dislocation
• Ankle Sprain Posterior Tibial Tendon

All of these findings are seen in association with an ankle sprain.  Each of the above problems has a different requirements for treatment both in the acute early sprain period and in the long term period after the sprained ankle is improved.

What is critical to consider is that with a sprained ankle and associated problems, it is critical to hold the ankle in the proper position while it is healing especially in the first two to three weeks.

Best Acute Ankle Sprain Treatments:

• Ankle brace
• Ice
• Elevation
• Physical Therapy
• Boot
• Possible Casting
• Possible Crutches

In most cases, an ankle brace with ice and elevation is an ideal start.  If the sprain is severe, a cast or a boot may be used in the short term to allow the ligaments to heal prior to placing a brace. Again it is essential to make sure that there is no tendon tear or fracture prior to treating an ankle sprain as a sprain.  If there is a simple ankle sprain, physical therapy is an excellent option to reduce swelling and pain and allow an expedited recovery.  

One of the most important recovery training programs after the ankle sprain begins to resolve at about 3 weeks is single leg stance for 30 seconds at a time.  The single leg stance exercises need to be done for about 5 minutes a day broken into two times per day. As the ankle gets stronger, the single leg stance can be done with eyes closed to working on balance.

If ankle pain continues at one month after injury, an MRI is suggested to check the tendons, ligaments and bones for damage that may not be seen on an x-ray or with physical exam. 

A Quick Tips Guide for a Sprained Ankle:

• Ice and elevate the ankle
• Wear a sturdy ankle brace to hold the ligaments stable
• Check the ankle with a doctor and get x-rays asap
• Wear a boot or cast and use crutches if it is a severe sprain or if there is a fracture or tendon tear
• Begin Physical therapy as soon as possible to calm swelling and get stability exercises started
• Wear a brace full time after injury for 6 weeks
• Wear an ankle brace during sports for about 3 months after injury
• Continue with physical therapy until ankle is stable and there is no pain with activity
• Get an MRI if ankle pain does not significantly improve at one month

For further information, please find attachments to a small number of our comprehensive published articles.  These articles will give more detailed information regarding ankle sprains, sprained ankle treatments and potential chronic ankle instability issues.

Published Articles Relating to Ankle Sprains:

docs/AnkleSprains.pdf

docs/currentconceptstreatingchronicankleinstability.pdf

docs/DetectingTheCauseOfChronicAnklePain.pdf

University Foot and Ankle Institute of California has extensive experience in the treatment of acute and chronic ankle sprains including heel bone spurs.  We have performed a great deal of research on the optimal treatment for a sprained ankle and also associated problems.  For an appointment or further information about ankle sprains, please call toll free (877) 677-0011 or contact us today.