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Sprain Sprain Go Away

Ankle sprains can be very frustrating, but there are some simple things you can do to help your recovery and get back to action faster.

First let's talk about what happens with an ankle sprain. The most common type of ankle sprain happens when you step off a curb, land on someone's foot or change directions awkwardly. Your foot bends down and in, and the ligaments on the outside of your ankle, typically towards the front (the anterior talofibular ligament) are stretched past their normal range of motion. A mild to moderate sprain typically includes stretching or a small amount of tearing of part of the ligament. There can be some pain, swelling and sometimes mild bruising. These are natural reactions to the injury. The pain and swelling are even part of the healing process. Severe sprains involve tearing of a significant portion of the fibers and sometimes fractures to the nearby bones can occur. This typically involves significant swelling, bruising and pain. If you think you may have a severe sprain or fracture or you just don’t know, you should consult a medical professional.

So what do we do in our office to help treat mild to moderate ankle sprains. The old advice of Rest, Ice, Compression and Elevation has been updated. We do recommend relative rest. If you just sprained your ankle, joining your friends for a game of pickup soccer is probably not the best idea. Ice is fine if you are in pain, but make sure you allow the area to warm back up sufficiently before activity and be sure to avoid frostbite (do not continue to ice an area that is already numb). Compression and elevation can be helpful. But the number one thing we tell people to do is to move their ankle. The motion should be pain free or very close to it. But the natural movement of your muscles is one of the best ways to maintain good circulation and promote the exchange of nutrients in the damaged tissues to help them heal faster. So you can do comfortable circles, write the alphabet or imagine you are painting a masterpiece with your toes, but try to do at least some movement, every hour while you are awake.

The next thing we have people work on is their balance. When you overstretch the ligaments in a joint, in this case your ankle, it can change your body's perception of where your foot is in space. Each time you take a step and put your foot down, if you aren't looking at it, you are probably stepping in a slightly different position than you normally would. This can lead to an increased risk for future sprains. So spend some time balancing on one leg. As you improve, you can stand on increasingly unsteady surfaces, or add additional challenges like moving your head or arms while you balance or closing your eyes. Make sure to do this in a safe environment and only to your tolerance and ability.

Finally, we add some strengthening. Since the ligaments were stretched by your foot going down and in, trying bringing your foot out and up. Strengthening the muscles that help control that motion can work to prevent or reduce the severity of future injuries and get you back to normal faster. You should feel the muscles on the front and outside of your leg working while you do this. If you reach far enough up and out, the exercise can actually be pretty difficult. Try doing a few sets of 10-15 reps. This is also a great movement to incorporate into your warm up as you return to activity. A couple of these before a run can really make a big difference. Like the above exercises this should not be painful.

There are plenty of other things that can be done to help, but the basics of gentle movement, working on balance, and strengthening the “up and out” muscles are a great place to start for a mild or chronic ankle sprain.

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