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Ankle Sprains: Recognition and Treatment

Primary care physican can treat most instead of ER

What is a sprain?

A sprain is a stretch and/or tear of a ligament, the fibrous band of tissue joining the end of one bone with another that stabilizes and supports the body's joints.

Because the outer ankle is more stable than the inner ankle, the foot is likely to turn inward (ankle inversion) from a fall, tackle, or jump. This stretches or tears ligaments; the result is an ankle sprain. The lateral ligament on the outer ankle is most prone to injury. As a result, virtually all ankle sprains are "inversion" sprains.

Symptoms and treatment of ankle sprains

As with burns, there are three "degrees" of sprains: mild (first-degree), moderate (second degree) and severe (third-degree). While the intensity varies, pain, bruising, and swelling (inflammation) are common to all three categories. 


ANKLE SPRAINS

First Degree (Mild)

Second Degree (Moderate)

Third Degree (Severe)

Description

Minor stretching of ligaments

Partial tear of ligaments

Complete tear of ligaments, or ligaments separate from bone

X-rays?

Not necessary unless suspect a fracture

Sometimes, depending on exam

Sometimes, depending on exam

Emergency room or doctor's office visit

Call doctor but, unless instructed by doctor to go to ER, wait to see doctor on next business day

Call doctor but, unless instructed by doctor to go to ER, wait to see doctor on next business day

Call doctor but, unless instructed by doctor to go to ER, wait to see doctor on next business day

Swelling?

Minimal; may not be swelling for several hours

Noticeable

Severe

Ankle Instability?

No

Yes (mild)

Yes (unable to bear any weight)

Painful to stand and walk?

No

Yes

Yes. Excruciating pain at moment of injury

Treatment

RICE plus crutches (rent at medical supply store) until can bear weight well (recovery time varies from a few days to a week);

RICE plus cast and crutches for two to four weeks; surgery may be necessary

From 2 days up to a week

Usually 2 to 3 weeks (after physical therapy), but possibly as long as 6 weeks

Recovery after intensive physical therapy may take 6 to 8 weeks

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It stands to reason that not

It stands to reason that not all sprains are the same. Especially when you consider that the original joint health of the athelete is what determines the severity of an injury. Of course, the intensity of the situation during play has a lot do do with it too. I'm not discounting that at all. Nevertheless, if a player has the proper stability to begin with, then they may have fared better at that particular moment. In other words, an injury may have been prevented, or been less severe.
It's never a fun situation, that's for sure. I've had more injuries than I want. I feel for those who are hurt, but want to play. I suspect much more could be done to prevent these problems. I wish I would have been paying more attention to what my body was telling me, prior to getting hurt.
100Meter
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Sprint Enthusiast | Intervals Rock!

Good comment

Thanks for your input, 100Meter. A good point about stability. The problem with sprains really is exacerbated for kids who have developed chronic ankle instability (see article at http://www.momsteam.com/health-safety/muscles-joints-bones/ankle-foot/we...). Ankle braces have been proven to help prevent first-time ankle sprains in volleyball, so that athletes don't develop a chronic problem with sprains. See http://www.momsteam.com/health-safety/ankle-brace-helps-prevent-ankle-in...

Nice job! alot of usefull

Nice job! alot of usefull information, thank a lot!

Glad to help

You are welcome. Look for more sports injury stuff in 2011. We are bringing on a new sports medicine guy to be another expert as part of the MomsTeam team who lives and breaths sports medicine, so we will have even more to offer sports parents on the injury prevention and treatment front.