Q&A Topic: Ankle Sprains

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Kurt Voellmicke, MD, FAAOS

Q. Did I simply twist my ankle, or is it a sprain?

A. Confusion over what constitutes a sprained ankle is common. A sprain is defined as a stretched or torn ligament—the tough, fibrous tissue that connects one bone to another and supports your joints. By far, the most common type of sprain is in the ankle. Ankle sprains happen when the foot twists, rolls, or turns in a manner that causes the ligaments to stretch beyond their normal length. While the intensity varies, pain, bruising, swelling, and inflammation are common to all sprains.

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Q. If my ankle is swollen and tender, what should I do?

A. Be sure to practice RICE immediately: Rest, Ice, Compress, and Elevate. Sit or lie down, put your ankle up on some pillows, wrap it with an ace bandage, and ice it for 20 to 30 minutes several times a day.If you can’t put weight on the joint, you should see a doctor immediately. After the ankle is evaluated and other injuries, such as fractures or tendon damage, are ruled out, and depending on the severity of the sprain, you may be able to start rehabilitating your ankle.

Q. What can I expect from rehab?

A. With a severe sprain, I often put a boot on the patient for two weeks or so and start physical therapy to strengthen the ankle as soon as possible. One exercise patients can try is writing the alphabet in the air with their big toe. Another is standing on one foot with your eyes closed. The goal is to work up to a minute. This improves your balance and strengthens the muscles that stabilize your joint.Following through on rehab is key. The single highest risk factor for ankle sprain is having a history of sprain. Completing an appropriate rehabilitation program and utilizing at least short-term bracing will decrease future risk of an ankle sprain.

Northern Westchester Hospital
Director, Foot and Ankle Section
Orthopedic and Spine Institute

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