Ankle Injuries

Last reviewed by Dr.Mary on August 7th, 2018.

Ankles support the total weight of the body so ankle injuries are extremely common. Every year nearly 2 million individuals are treated for ankles strains, and sprains and fractures are some of the more common injuries to be treated by podiatrists and orthopedists.


Ankle Injuries – Symptoms

Tissue inflammation and injury happen when the ankle is sprained. The blood vessels start being “leaky” and this allows fluid to ooze into the tissues which are soft surrounding the joint. White blood cells migrate to the area in responses to the inflammation and the blood flow increases. The following are inflammation signs:

  • Swelling, because of increased fluid in the tissue, is often severe
  • Pain, the nerves are very sensitive. The joint hurts and could throb. The pain can worsen when the area is sore and is pressed or the foot moves in certain directions – depending upon which ligament is involved – and during standing and walking.
  • Warmth and redness: Caused by the increased blood flow to the area

Generally, an ankle injury does not necessitate an outing to your primary care physician. The difficulty is telling a minor injury from something more severe for instance a break. If one of the following occurs, contact your family physician:

  • Pain is not controllable with the usage of over the counter drugs, ice or elevation
  • The individual is not able to walk or can’t walk other than a couple of steps devoid of pain that is severe
  • The ankle doesn’t recover within 5 days to a week. The pain may not be totally gone but it needs to have gotten better.

The symptoms which are an indication to go to the emergency room include the following:

  • Severe or unrestrained pain
  • Unable to move the damaged ankle
  • The ankle or foot is distorted past what might happen with typical swelling
  • Cannot walk 4 steps, even by means of a limp
  • Experience pain which is severe when pressing over the lateral or medial malleolus which is the bony bumps on either sides of the ankle.
  • Experience loss of sensation in the toes or foot
  • Swelling and pain in the heel, over the Achilles tendon, or no ability to push the toes down –like pressing on the gas pedal of a car.
  • Swelling and pain in the upper area of the lower leg right below the knee or swelling of the muscle of the calf
  • Red streaks or redness spreading outwards from injury

Ankle Injuries – Diagnosis

The physician will do a physical exam to see if there is a fracture or other injury which is serious and needs immediate care. The exam should check that all the nerves or arteries to the foot have not been injured and that the knee as well as the rest of the leg is not involved. The doctor will also handle as well as move the ankle and foot to determine what bony areas are involved.

The Achilles tendon will need to also be checked for any signs of rupture.

X-rays are necessary in order to confirm or deny the presents of a fracture. In some cases of fracture, a CT scan might be needed.

Ankle Injuries – Treatment

Self-care at home

Any care at home will help to reduce the pain and aid healing. Since most of the pain is caused by inflammation, the goal is to prevent and reduce inflammation.

Remember RICE: rest, ice, compression as well as elevation

Rest

Rest prevents any further injury and keeps stress away from tissue which is already inflamed

  • Put the ankle joint at rest by wearing a splint or brace
  • Sprains which are more severe can be treated by using crutches

Ice

Ice is still the best treatment

  • Applying ice to any ankle injury will do more than medications
  • Ice can counteract the increased blood flow to the area which is injuried
  • Ice reduces redness, swelling as well as warmth
  • Applied immediate after an injury, ice stops much of the inflammation from developing
  • Don’t apply ice directly to the skin. Use a towel between the injury and the ice, or use an ice bag. Apply ice for 20 minutes at a time, with at least 30 minutes between applications. This is in order to prevent frostbite which often occurs if you use ice too much or use it directly on the skin.

Compression

Compression or strapping, provides support and helps prevent inflammation

  • Use Ace bandages such as elastic wraps immobilize the ankle
  • Do not apply wraps too tightly

Elevation

Keep the injured area up as high as possible – this will help the body to absorb the fluid that has leaked into the tissue

  • Ideally, prop the ankle up so that it is above the level of the heart
  • Sit in a chair that reclines or prop the legs up with a pillow
  • Anti-inflammatory pain medications such as ibuprofen and naproxen will reduce the pain and will combat the swelling.

Medical Treatment

Treatment by a physician will be very similar to home care, especially using the ice to reduce inflammation. The physician may elect to apply a brace or a cast to reduce motion of the ankle. Crutches are usually provided so no weight is on the injured ankle.

Common medications used for ankle injuries are anti-inflammatory pain drugs that both help control the inflammation and reduce pain. If the individual cannot tolerate these drugs, Tylenol or narcotics are common alternatives.

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