Dr. George L. Dixon - "Talking Fitness"

UNDERSTANDING SPRAINED ANKLES

Ligaments hook bones to bones. Tendons hook muscles to bones. An injury to a ligament is a sprain . An injury to a muscle is a strain.

Too often people are unaware of the severity of their ankle injuries, and therefore have long recovery periods. A ligament may be stretched a little or torn completely.

There are three grades of sprained ankle: mild, bad and awful. Let's call them grades one, two, and three.

A Grade 1 sprain usually occurs when you misstep suddenly. The ankle is swollen, and you experience medium pain. You are able to walk on your toes as well as your heel. CARE for grade 1 sprain includes walking carefully with an elastic band or strapping, and a high-top tennis shoe. Over-the-counter anti-inflammatory drugs such as asprin, ibuprofen or the new "Aleve" can shorten your misery. Start them NOW at the maximum dose on the lable. Exercise progressively, walking on your heels first, then on your toes.

A Grade 2 sprain usually occurs from a fall. You will experience worse pain and more swelling. You will only be able to walk on your heel, but not your toes. CARE for grade 2 includes a cane or crutch in addition to grade 1 care. If after three days of RICE treatment (see box), you cannot walk on your toes at least a little, you need to see a doctor. You will need a protective support, such as an air cast, and then exercises for 3-12 weeks.

A Grade 3 sprain is the same as grade 2 except you have more pain and extreme swelling. You can't bear weight on your foot at all. CARE for grade 3 includes a prompt visit to your doctor or to an emergency room. There may be a fracture or the ligaments may be completely torn. Your doctor may advise surgical repair and a cast, or just a cast to allow the ligaments to heal. Then you will need the rehabilitation stages of grade 2. Your ankle will need taping for all sports for three to six months to avoid recurrent sprains and chronic weakness.

Remember: The RICE treatment is important for all three grades of sprain.

You need medical help for some grade 2 and all grade 3 sprains. If you cannot walk on your toes or heel, don't waste three days waiting to see which grade of sprain you have: get to the ER or your doctor promptly.

RICE Treatment

Rest: avoid use, lie down, cane as needed.

Ice: ice off and on for 48 hours; not directly on skin.

Compress: light towel over-laid with elastic wrap, re-apply every 4-6 hours.

Elevate: lie down, foot higher than heart until most of swelling gone.