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Treating Ankle Sprains
The most common type of ankle injury is a sprain. A sprain is stretching and tearing of ligaments. There are many ligaments around the ankle and these can become damaged when the ankle is forced into an unnatural postion.
The most frequently seen sprain occurs when weight is applied to a foot which is on an uneven surface, and the foot "rolls in" (inversion). Because the sole of the foot is pointing inward as force is applied, the ligaments stabilizing the outside part of the ankle are stretched and stressed. Many patients report hearing a "snap" or "pop" at the time of the injury. This is usually followed by pain and swelling on the outside of the ankle.
You will often hear the acronym RICE in conjunction with sprain treatment this means...
R - rest
I - ice
C - compression
E - elevation
Many of the problems resulting from sprains are due to blood and swelling in and around the ankle joint. Minimizing swelling helps the ankle heal faster. The RICE regimen facilitates this.
How do I carry out the RICE regimen?
Rest - no weight bearing for the first 24 hours after the injury (Possibly longer, depending upon severity)
Ice - apply ice packs using a towel over a plastic bag to the area that is painful. Be careful to avoid frostbite. Ice should be intermittantly applied for the first 24 hours.
Compression - an elastic bandage or air cast should be applied to the ankle to help prevent the accumulaton of edema.
Elevation - elevating the ankle helps in removing edema. By having the foot higher than the hip (or heart), gravity is used to pull edema out of the ankle.
In the initial 24 hours, it is very important to avoid things which might increase swelling. Following is a list of things to avoid:
- hot showers
- heat rubs (such as "Ben Gay")
- hot packs
- drinking alcohol
- aspirin
After the initial 24 hours the patient can begin partial weight bearing using crutches. Gradually progressing to full weight bearing over several days as tolerated. The patient should try to use a normal heel-toe gait. An ankle brace may be necessary to protect the joint from reinjury. As soon as pain allows, rehabilitation exercises should be done.
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