Most of us know the immediate pain of a twisted ankle, but ankle sprains, when misdiagnosed and treated incorrectly, can produce lingering effects. What exactly is an ankle sprain, why can it take so long to heal, and what can be done to reduce the chance of re-injury?
An ankle sprain refers to damage to the ligaments holding the bones of the ankle together. Ligaments are like short, tough straps that prevent excessive movement. They don’t stretch, like muscle does, and they receive little blood supply. That means they don’t heal like skin or muscle does. They scar down to heal. As a result, it takes a long time for ligaments to recover.
Most ankle sprains occur when the foot twists underneath so that the sole of the foot faces inward, straining the ligaments on the outside of the ankle. It can happen in sports, such as landing on someone’s foot while going up for a rebound, or just by stepping off a curb wrong.
Keeping the ankles from twisting too much are small receptors in the ankle joints that send signals to the brain and continually update the brain on how much stress is being put on the ankle as it takes different positions. This means that when you are running down a field and step into a small hole, your ankle sends a signal to your brain, indicating the stretch on the side of the foot and ankle. Your brain then sends a reply to your entire body to respond and protect your ankle by shifting body weight to limit damage to your ankle. When repeated injuries occur to the same ankle, that ankle’s receptors become damaged, and the ankle is more susceptible to injury.
Initial treatment for an ankle sprain is RICE, which stands for rest (crutches to take the weight off the foot), ice, compression and elevation of the foot above the heart. It is important to have the ankle X-rayed to detect a fracture. When a fracture has been ruled out, and with your doctor’s okay, you can do gentle home exercises to help reduce swelling and regain motion.
Moving the foot down, like stepping on the gas pedal, followed by pulling it up as far as possible and repeating this 10-20 times several times a day, with the leg elevated, helps pump fluid out of the ankle. Curling the toes hard also helps. And moving the foot to trace the letters of the alphabet is an excellent way to repair all the motions of the foot and ankle.
Physical therapy after an ankle sprain is very important in regaining full use. Manual lymphatic drainage, a hands-on technique widely used in Europe, is a wonderful way to reduce swelling and pain initially. After swelling is reduced, normal function can be restored by taping or bracing the ankle and mobilizing the joint to restore normal alignment of structures in the ankle that may be compressed or jammed.
Then, specialized exercises are given to regain strength and agility, and reactivate the receptors to relay position information to the brain. Depending upon someone’s athletic needs, a carefully done routine of jumping, running and lateral motions is in order to lessen the chance of re-injury.
A severe ankle sprain can take longer to heal than a fracture, but with the right treatment, anyone can return to function.