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| Putting Ankle Pain on Ice by Michael Adesso |
| Sprained ankles are one of the most common injuries in sports. |
| Quite often, these injuries are thought to be mild, and people do not seek treatment. This can sometimes lead to further problems, especially in athletes who play “stop and go” sports. |
| Sometimes, people who have more serious ankle sprains may actually do better in the long run, because they seek out medical attention and receive proper treatment. |
| What actually constitutes a “sprain?” |
| Joints are connected by ligaments, and they are tough, relatively inelastic structures that provide stability to the joint. We grade ligament injuries as mild (Grade 1), moderate (Grade 2) or severe (Grade 3). |
| With a Grade 1 injury, a patient will usually have mild swelling and pain. In most cases he or she will still be able to continue to play with this injury. |
| Grade 2 injuries involve moderate to severe pain and swelling. It is not possible to comfortably bear weight without the help of crutches. With this injury, some of the ligament fibers are torn, which makes the joint less stable. |
| A Grade 3 sprain may involve a complete tear of the ligaments. Most people seek out immediate medical attention for a Grade 3 sprain. |
| Sprains of all grades may be treated with x-rays (to rule out fractures), ice, immobilization (with a brace or cast), crutches, rest, and rehabilitation. Your doctor will decide what degree of injury you have and recommend the proper course of treatment. |
| Complications of an ankle sprain may include swelling, loss of the balance mechanism and limited movement. The balance mechanism is the joints ability to sense position in space, and relay that information to the brain. Our muscles can then make the necessary adjustments to keep us upright and moving. |
| Some of the receptors that help us do this are found in the ligaments. Ligament injury, therefore, will affect the efficiency of this system. Many of the exercises prescribed for people in rehab are based on returning to normal balance. If left untreated, as in many mild ankle sprains, this can contribute to recurring ankle sprains. |
| Another complication is swelling. In the moderate to sever ankle sprains, the early focus of treatment is to reduce swelling. There is ongoing research and debate about the best way to decrease swelling. At home, the RICE (rest, ice, compression, elevation), is a good way to manage swelling. Lingering swelling can limit range of motion, which will hamper return to full activity. |
| Do not place the ankle in a bucket of ice water, since this will actually be too cold, and it means the ankle won’t be elevated. A bag of frozen vegetables and an ace bandage will provide cold and compression. Have a light barrier between the ice and your skin, so the temperature is cool, not freezing. |
| Rest is also an important part of getting better. We like to use the term “active rest”. Though you may need some complete down time for healing, too much inactivity can lead to stiffness and loss of strength in the joint. By performing controlled amounts of stress (range of motion and strength exercises), you will promote healing. |
| Too much stress, however, will keep you sore and swollen. This is the challenge of the rehab process, to gradually ad activities and return to normal. |
| One final point: the body is a link system. When one body part has lost some function, it can affect other areas. An example of this would be developing shoulder or elbow pain from an ankle that is not completely healed. |
| To throw efficiently, the arm and trunk go through a whipping motion. You must be able to stop the momentum of your body with your plant foot, to allow your arm to follow through with maximum velocity. If your ankle cannot provide this stable base, other body parts will try to slow down your arm. This could result in shoulder, elbow or low back pain. |
| All of this advice is intended as a guide, not a substitute for a doctor’s evaluation. Consult your doctor when you suspect ankle sprain. |
| Michael Adesso, PT, ATC Director of Physical Therapy University Sports Medicine Amherst Location |