FAQs: Ankle Sprains

Common Questions About Ankle Sprains:

“Should I get my ankle x-rayed, it’s probably just a sprain?” The safest thing to do is get the x-ray, as it is difficult to distinguish a fracture from a sprain, even by careful physical exam.

“Can I run through this sprain?” If you can walk briskly without pain after a sprain, it is reasonable to try some light jogging on well-lit, smooth surfaces without cutting.

“What is the best way to use ice?” Ice works well to reduce pain and swelling for 48-72 hours after injury. Do not apply ice directly to the skin. Alternating on-off periods of twenty or thirty minutes makes sense. Use a big bag, with small loose ice chips, hung like saddlebags around the ankle and foot. (for more information, go to: www.genufix.com/hot_and_cold_therapy/htm)

“What further problems can follow sprains?” Although most ankle sprains resolve over days to weeks without further problems, at least three specific complications can result: recurrent instability, i.e.- more sprains; concomitant talus fractures producing symptomatic loose bodies (catching, locking, giveaway, swelling); and impingement (pinching, painful scar tissue within the ankle joint).

“Should I wear a brace?” During early return to activity, especially with cutting and twisting sports, a supportive brace (orthosis) may be helpful, but is no substitute for adequate rehabilitation.

“Should I tape my ankle?” If you know how, taping can provide stability, but like bracing, is not a substitute for adequate rehabilitation, consisting of strengthening and balance exercises. Studies have shown that the value of taping diminishes with time (i.e.- tape applied before a basketball game will be loose by the second half).

“Darn it! This is the ‘Nth’ sprain I have had with this ankle! Why does this keep happening?” Although virtually every human being will sprain their ankle during their lifetime, few have numerous recurrences. In some cases, the ligaments “heal loose”. If intensive efforts at peroneal muscle strengthening, shoe modifications, and bracing do not resolve instability, occasionally surgery may be necessary to tighten or reconstruct the lateral ligaments in an attempt to solve the problem.

“Why does the purple color and swelling go all the way to my toes?” When the ligaments are injured they bleed, and the blood can seep all the way to the toes, especially if you are on your feet much of the time.

“I keep spraining my ankle, but two other doctors say that my ankle is stable and there is no explanation, I am just having bad luck.” There are some conditions that are rare, but can masquerade as an ankle sprain. In children, a condition called “tarsal coalition” (fusion of the foot bones) can behave as a sprain. In other cases, a loose fragment of bone or cartilage can cause giveaway ankle symptoms resembling a sprain. Furthermore, the lateral peroneal tendons can escape from their groove causing pain and instability. When in doubt, have it checked out by a specialist.

“Do sprains cause arthritis?” Not usually. Arthritis that follows ankle injury typically occurs after multiple severe sprains, or more commonly, fractures (which is why it is wise to have the ankle x-rayed following injury.

“Are all sprains the same?” Absolutely not! Sprains vary greatly in degree (grade), a reflection of severity. Although most sprains are of the inversion type, with lateral, or outside injury, the medial, or inside (deltoid) ligaments can also be injured, either along with the lateral, or as an isolated injury. In addition, there exists a “syndesmotic sprain”, more common in athletes, that results from trauma to the ligaments that connnect the two bone of the lower leg (tibia and fibula), immediately above the ankle. The syndesmotic sprain is well-known for its slow course of recovery.