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Sprained Ankle
This is the most common sports injury. Ankle sprains are categorized into 3 grades based on their severity and involve primarily 2 ligaments, the anterior talofibular and the calcaneofibular ligament. Please visit your physician in order to determine what grade sprain you are suffering from and how many ligaments are involved. This will help determine the appropriate care you should recieve and maximize your healing rate.
Risk Factors bad shoespoor surface conditionspast history of ankle sprains / injuriespoor biomechanics
Symptoms
Grade I symptoms due to slight stretching and/or minimal tearing of the anterior talofibular ligamentslight to moderate pain with little to no functional losssome joint swelling and stiffness with minor bruising (ecchimosis)plan on missing about 4 to 7 days of sports activity
Grade IIsymptoms due to more severe stretching and tearing of the anterior talofibular ligament however not a complete rupturemoderate joint instabilitymoderate to severe pain, weight bearing causes severe painjoint swelling and stiffness with ecchimosisplan on missing 7 to 10 days of sports activity
Grade IIIsymptoms due to complete tear of the anterior talofibular ligament and may also involve the calcaneofibular ligamentsevere joint instability with loss of functioninitially severe pain, then may be followed by period of no painsevere swelling and stiffness with ecchimosisplan on missing 2 to 3 weeks of sports activity with single ligament involvementplan on missing 5 weeks or so of sports activity with double ligament involvment
Treatments
No matter what grade of sprain you have, it is very important in the first 24 hours to minimize activities that can increase the swelling such as: hot showers/packs, heat rubs, drinking alcohol, and use of Aspirin (Aspirin decreases clotting time, and therefore allows more bleeding into the ankle).
For single ligament injuries (anterior talofibular ligament)
Grade I resticecompression wrap (for approximately first 72 hours)elevate the ankleweight bearing as tolerated, may use crutchesno splinting or casting requiredsoft tissue therapies / massagestretches and strengthening exercises as toleratedwarm baths / whirlpool after 72 hours, once a day
Grade II*resticecompression wrap (for approximately 5 days)elevate the ankleuse crutchessoft tissue therapies / massagewarm bath / whirlpool after 5 days, once a day
Grade III*resticecompression wrap initially, then a semi-rigid cast (for approximately one week)elevate the anklesoft tissue therapies / massagewarm bath / whirlpool after 10 days, twice a day, with range of motion exercises performed while in whirlpoolfollowing a week of whirlpool baths, begin stretching exercises
*Once full range of motion has returned with Grade II and II sprains, strengthening exercises may initiated
For 2 ligmanet injuries (anterior talofibular and calcaneofibular ligament)
Grade III After first 24 hours, use a walking cast, set at a 90 degree angle and keep using it for approximately 3 weeks2 warm soaks per dayas soon as possible, begin a series of exercises to regain ankle mobilityover next 6 months, ankle tape support should be used with every activity
Prevention wear high top sneakerstape ankles prior to sports activity or wear an ankle brace / support
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