Sprained Ankle – OrthoInfo – AAOS

Ankle sprains are common injuries that occur among people of all ages and at all activity levels; in fact, they are the number one reason for missed participation in athletics. 

An ankle sprain occurs when the strong ligaments that support the ankle stretch beyond their limits and tear. The severity of a sprain can vary greatly depending on the number of ligaments involved and the extent to which the ligaments are torn.

Most sprains heal with conservative treatments like ice, elevation, over-the-counter medications, and simple rehabilitation exercises. However, if your ankle remains swollen or painful for several weeks despite conservative treatments, or if you have difficulty putting weight on your ankle, you may need to be evaluated to ensure that you do not have a severe ankle sprain or fracture.

If symptoms do not improve despite non-operative treatment, you may need surgery to repair or reconstruct the injured ligaments.  

Without proper treatment and rehabilitation, a chronic or untreated severe sprain can weaken your ankle, making it more likely that you will injure it again. Repeated ankle sprains can lead to long-term problems, including chronic ankle pain, arthritis, and instability.

Ligaments are strong, fibrous tissues that connect bones to other bones throughout the body. Numerous ligaments in the ankle help to keep the bones in proper position and stabilize the joint. Joint stability is important for all types of activities, including standing, walking, and running.

An ankle sprain is an injury to one or more of the ligaments that stabilize the ankle.

Reproduced from J Bernstein, ed: Musculoskeletal Medicine. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2003.

• Around 90% of ankle sprains involve an inversion injury (the foot turns inward) to the anterior talofibular (ATFL) and calcaneofibular (CFL) ligaments — the lateral ligaments on the outside of the ankle.  
• The less common medial ankle sprain is caused by an eversion injury (the foot turns out) to the deltoid ligament on the inside of the ankle. 

Sprains can range from tiny tears in the fibers that make up the ligament to complete tears.

If there is a complete tear of the ligaments, the ankle may become unstable after the initial injury phase passes. Over time, this instability can result in damage to the bones and cartilage, the smooth lining of the joint.

The lower leg or foot can roll, or invert, leading to a sprain of the ligaments on the outside of the ankle.

Reproduced from the Body Almanac @ American Academy of Orthopaedic Surgeons, 2003.

Patients often recall a twisting injury to their foot or ankle. If there is severe tearing of the ligaments, you might also hear or feel a pop. Sprains may occur  unexpectedly during many different activities, such as:

• Walking or exercising on an uneven surface
• Falling down or tripping
• Participating in sports that require cutting or jumping actions, such as trail running, basketball, tennis, football, and soccer

The types and severity of symptoms for a sprained ankle vary widely depending on the degree of the injury. Symptoms may include:

• Pain, both at rest and with weightbearing or activity
• Swelling
• Bruising
• Tenderness to touch
• Instability of the ankle, or feeling that your ankle is giving out

Symptoms of a severe sprain are similar to those of a broken bone and require prompt medical evaluation. 

Bruising and swelling are common signs of a sprained ankle. Symptom severity varies depending on the degree of injury to the ligaments. 

Physical Examination

Your doctor will diagnose your ankle sprain by asking you questions about the injury and performing a careful examination of your foot and ankle. Due to the swelling and inflammation, this physical exam may be painful and often includes:

• Observation. Your doctor will look at the injured ankle and compare it to your other ankle. Often, the sprained ankle is swollen and bruised over the injured ligaments. 
• Palpation.  Tenderness is often limited to the area directly over the injured ligaments. Your doctor will gently press around the ankle to determine which ligaments are injured.
• Range of motion testing. The doctor may move your ankle in different directions; however, it may be difficult to move a stiff, swollen ankle.
• Stability testing. Your doctor may manipulate or pull your ankle in several directions in a controlled manner to assess the stability of the ankle joint.

Your doctor may be able to tell the severity of your ankle sprain based on the amount of swelling, pain, bruising, and stability. If you have difficulty bearing weight, or tenderness in the bones of the foot and ankle, you may need additional tests to rule out a fracture. 

To diagnose a sprain, your doctor will gently palpate around the outside of the ankle in the area of the pain (arrow).

Reproduced from JF Sarwark, ed: Essentials of Musculoskeletal Care, ed 4. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2010.

Imaging Tests

An ankle sprain is largely a clinical diagnosis based on how the injury happened, symptoms, and examination by a medical professional. Occasionally, imaging studies, such as X-rays and magnetic resonance imaging (MRI) scans, are obtained to rule out a fracture or other injury to the nearby tendons and cartilage. 

X-rays. X-rays provide images of dense structures, such as bone. Depending on your symptoms and examination, your doctor may order X-rays to evaluate the bones in your ankle and foot. Severe ankle sprains can have a similar degree of pain, bruising, and swelling as a fracture, making it difficult to distinguish between the two. 

Stress X-rays. In addition to plain X-rays, your doctor may also order stress X-rays. These images are taken while the ankle is being pushed in different directions in a controlled manner. Stress X-rays help to show whether the ankle is unstable because of injured ligaments.

Magnetic resonance imaging (MRI) scan. An MRI scan is not required to diagnose ankle sprains. Your doctor may obtain an MRI:

• To evaluate other structures, such as cartilage and tendons, around the ankle
• If you exhibit signs of a high ankle sprain — an injury to the ligaments and structures connecting the bones of the lower leg (tibia and fibula)
• If your symptoms persist beyond 6 to 8 weeks after the injury despite conservative treatment

After the examination, your doctor will determine the grade of your sprain to help develop a treatment plan. Sprains are graded based on how much damage has occurred to the ligaments.

Grade 1 

• Slight stretching and microscopic tearing of the ligament fibers
• Mild tenderness, bruising, and swelling around the ankle
• Typically no pain with weightbearing
• No instability on examination

Grade 2 

• Partial tearing of the ligament
• Moderate tenderness, bruising, and swelling around the ankle
• Mild pain with weightbearing
• Slight instability on examination

Grade 3 

• Complete tear of the ligament
• Significant tenderness, bruising, and swelling around the ankle
• Severe pain with weightbearing
• Substantial instability on examination

A Grade 2 sprain results in partial tearing of the ligament or ligaments. This commonly leads to moderate swelling and bruising above and below the ankle joint.

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Nonsurgical Treatment

Nearly all isolated low ankle sprains can be treated without surgery. Even a complete ligament tear (Grade 3) will heal without surgical repair if it is immobilized and rehabilitated appropriately.

A three-phase program guides treatment for all ankle sprains — from mild to severe:

Phase 1

• Includes a short period of immobilization, rest, and ice to reduce the swelling.
• Early weightbearing as tolerated is typically recommended during this phase.
• For a Grade 2 sprain, a removable plastic device, such as a walking boot or aircast brace, can provide support.
• Grade 3 sprains may require a short leg cast or cast-brace for 10 to 14 days.
• In most cases, swelling and pain will last 2 to 3 days. Walking may be difficult during this time, and your doctor may recommend that you use crutches as needed.

Phase 2

• Is typically initiated early and includes functional rehabilitation that focuses on:
  • Range of motion exercises
  • Isometric strengthening
  • Proprioception (balance) retraining exercises
• It is important to discontinue ankle immobilization during this phase to avoid stiffness. 

Phase 3

• Includes advancement of strengthening and proprioception exercises and the gradual return to pre-injury activities. This begins with activities that do not require turning or twisting the ankle, followed later by activities that require sharp, sudden turns (cutting activities), such as tennis, basketball, or football.
• Early return to sporting and work activities may require ankle taping or bracing. 

This three-phase treatment program may take just 2 weeks to complete for minor sprains, or up to 6 to 12 weeks for more severe injuries.

Home Treatments

For milder sprains, your doctor may recommend simple home treatment.

The RICE protocol. Follow the RICE protocol as soon as possible after your injury:

• Rest your ankle by not walking on it or returning to sport. 
• Ice should be immediately applied to keep the swelling down. It can be used for 20 to 30 minutes, 3 or 4 times daily. Do not apply ice directly to your skin.
• Compression dressings, bandages, or ace-wraps will immobilize and support your injured ankle. The compression may also help with swelling.
• Elevate your ankle above the level of your heart as often as possible during the first 48 hours. Elevation also helps control the swelling.

Medication. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen can help control pain and swelling. Because they improve function by both reducing swelling and controlling pain, they are a better option for mild sprains than narcotic pain medicines.

An air stirrup-type ankle brace.

Reproduced from JF Sarwark, ed: Essentials of Musculoskeletal Care, ed 4. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2010.

Physical therapy. Rehabilitation exercises during phase 2 and 3 of recovery are used to improve flexibility, strength, and proprioception (balance).

• Early motion. To prevent stiffness, your doctor or physical therapist will provide you with exercises that involve range-of-motion or controlled movements of your ankle without resistance.
• Strengthening exercises. Once the swelling and pain have improved, exercises to strengthen the dynamic stabilizers (muscles and tendons) in the front and back of your leg and ankle will be added to your treatment plan. Water exercises may be used if weightbearing strengthening exercises, such as toe-raising, are too painful. Exercises with resistance are added as tolerated.
• Proprioception (balance) training. Poor balance often leads to repeat sprains and ankle instability. A good example of a balance exercise is standing on the affected foot with the opposite foot raised and eyes closed. Balance boards are often used in this stage of rehabilitation.
• Endurance and agility exercises. Once you are pain-free, other exercises, such as agility drills, may be added gradually. Running in progressively smaller figures-of-8 is excellent for agility and calf and ankle strength. The goal is to increase strength and range of motion as balance improves over time.

Once you are pain-free, resistance exercises may be added to your therapy program to strengthen the muscles around your ankle.

Reproduced from JF Sarwark, ed: Essentials of Musculoskeletal Care, ed 4. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2010.

Surgical Treatment

Surgical treatment for ankle sprains is rare.

• Surgery is reserved for injuries that fail to respond to nonsurgical treatment, and for patients who experience persistent ankle instability and pain after months of rehabilitation and nonsurgical treatment.
• Surgery may also be indicated for some high ankle sprains with instability of the ankle syndesmosis.
• Sometimes surgery is recommended if a severe ankle sprain is associated with additional injuries, such as an ankle cartilage injury or tendon rupture.

This X-ray shows extreme instability of the ankle.

Espinosa N, Bluman EM: Lateral Ankle Ligament Reconstruction Using Allograft, in Flatow E, Colvin AC, eds: Atlas of Essential Orthopaedic Procedures. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2013, pp 349-355.

Types of surgery

Surgical options include:

• Arthroscopy. During arthroscopy, your doctor uses a small camera, called an arthroscope, to look inside your ankle joint. Miniature instruments are used to remove any loose fragments of bone or cartilage, or parts of the ligament that may be caught in the joint.
• Repair/reconstruction. Your doctor may be able to repair the torn ligament with stitches or sutures. In some cases, they will reconstruct the damaged ligament by replacing it with a tissue graft obtained from other ligaments and/or tendons found in the foot and around the ankle.

Recovery

Immobilization. There is typically a period of immobilization after surgery. A cast or protective boot is applied to protect the ligaments. Be sure to follow your doctor’s instructions about how long to wear the protective device; early mobility or weightbearing can re-tear the repair or the reconstructed ligament.

Rehabilitation. Rehabilitation after surgery involves restoring strength and range of motion so you can return to pre-injury function. The length of time you can expect to spend recovering depends on the extent of injury and the surgery that was performed. Rehabilitation may take weeks to months.

Outcomes for ankle sprains are generally quite good. With proper treatment and rehabilitation, most patients are able to resume their day-to-day activities after a period of time. Successful outcomes and return to activity depend on:

• The grade of the sprain.
• Whether there are other injuries.
• The patient’s commitment to rehabilitation exercises. Incomplete rehabilitation is the most common cause of chronic ankle instability after a sprain. If a patient stops doing the strengthening exercises, the injured ligament(s) will weaken and put the patient at risk for future ankle sprains.

Chronic Ankle Sprains

Once you have sprained your ankle, you may continue to sprain it if the ligaments do not have time to completely heal. This can happen if you return to work, sports, or other activities before your ankle heals and is rehabilitated. It may be difficult to determine whether the ligament is completely healed, but symptoms (pain and swelling) can often guide the advancement of physical therapy and function.  

If pain continues for more than 4 to 6 weeks, you may have a chronic ankle sprain. Things that tend to make an already sprained ankle worse include:

• Stepping on uneven surfaces
• Participating in sports that require cutting actions, or rolling and twisting of the foot

Abnormal proprioception — a common complication of ankle sprains — can also lead to repeat sprains.

Reinjury may result in chronic instability, pain, and damage to the underlying cartilage and bones.

The best way to prevent ankle sprains is to maintain good muscle strength, balance, and flexibility. The following precautions will help prevent sprains:

• Warm up thoroughly before exercise and physical activity.
• Perform strengthening exercises to enhance your ankle stability.
• Pay careful attention when walking, running, or working on an uneven surface.
• Choose footwear with appropriate support for your activity.

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Recovering from an ankle sprain

All it takes is a simple misstep, and suddenly you have a sprained ankle. An ankle sprain is one of the most common musculoskeletal injuries in people of all ages, athletes and couch potatoes alike. The injury occurs when one or more of the ligaments in the ankle are stretched or torn, causing pain, swelling, and difficulty walking. Many people try to tough out ankle injuries and don’t seek medical attention. But if an ankle sprain causes more than slight pain and swelling, it’s important to see a clinician. Without proper treatment and rehabilitation, a severely injured ankle may not heal well and could lose its range of motion and stability, resulting in recurrent sprains and more downtime in the future.

Anatomy of an ankle sprain

The most common type of ankle sprain is an inversion injury, or lateral ankle sprain. The foot rolls inward, damaging the ligaments of the outer ankle — the anterior talofibular ligament, the calcaneofibular ligament, and the posterior talofibular ligament. (Ligaments are bands of fibrous tissue that connect bone to bone; see illustration. )

Less common are sprains affecting the ligaments of the inner ankle (medial ankle sprains) and syndesmotic sprains, which injure the tibiofibular ligaments — the ligaments that join the two leg bones (the tibia and the fibula) just above the ankle. Syndesmotic sprains, which occur most often in contact sports, are especially likely to cause chronic ankle instability and subsequent sprains.

The severity of an ankle sprain depends on how much damage it does and how unstable the joint becomes as a result. The more severe the sprain, the longer the recovery (see “Grades of ankle sprain severity”).

 How to treat a sprained ankle

The first goal is to decrease pain and swelling and protect the ligaments from further injury. This usually means adopting the classic RICE regimen — rest, ice, compression, and elevation. If you have severe pain and swelling, rest your ankle as much as possible for the first 24–48 hours. During that time, immerse your foot and ankle in cold water, or apply an ice pack (be sure to cover the ankle with a towel to protect the skin) for 15–20 minutes three times a day, or until the swelling starts to subside.

To reduce swelling, compress the ankle with an elasticized wrap, such as an ACE bandage or elastic ankle sleeve. When seated, elevate your ankle as high as you comfortably can — to the height of your hip, if possible. In the first 24 hours, avoid anything that might increase swelling, such as hot showers, hot packs, or heat rubs.

When to see your doctor

Unless your symptoms are mild or improving soon after the injury, contact your clinician. He or she may want to see you immediately if your pain and swelling are severe, or if the ankle feels numb or won’t bear weight. He or she will examine the ankle and foot and may manipulate them in various ways to determine the type of sprain and the extent of injury. This examination may be delayed for a few days until swelling and pain improve; in the meantime, continue with the RICE regimen.

X-rays aren’t routinely used to evaluate ankle injuries. Ligament problems are the source of most ankle pain, and ligaments don’t show up on regular x-rays. To screen for fracture, clinicians use a set of rules — called the Ottawa ankle rules, after the Canadian team that developed them — to identify areas of the foot where pain, tenderness, and inability to bear weight suggest a fracture. A review of studies involving more than 15,000 patients concluded that the Ottawa rules identified patients with ankle fractures more than 95% of the time.

How to strengthen your ankle after a sprain

To recover from an ankle sprain fully, you’ll need to restore the normal range of motion to your ankle joint and strengthen its ligaments and supporting muscles. Studies have shown that people return to their normal activities sooner when their treatment emphasizes restoring ankle function — often with the aid of splints, braces, taping, or elastic bandages — rather than immobilization (such as use of a plaster cast). Called functional treatment, this strategy usually involves three phases: the RICE regimen in the first 24 hours to reduce pain, swelling, and risk of further injury; range-of-motion and ankle strengthening exercises within 48–72 hours; and training to improve endurance and balance once recovery is well under way.

Generally, you can begin range-of-motion and stretching exercises within the first 48 hours and should continue until you’re as free of pain as you were before your sprain. Start to exercise seated on a chair or on the floor. As your sprained ankle improves, you can progress to standing exercises. If your symptoms aren’t better in two to four weeks, you may need to see a physical therapist or other specialist.

Survival skills

A sprained ankle or an accident can turn any vacation or trip into a serious ordeal. Therefore, survival skills in nature are so important for modern man.

The key to survival in nature is preparation. And it’s not stocks of food and equipment. It’s about the skills you need to learn and remember to save your life if, for example, your car breaks down in the middle of a forest or you get lost on a tourist route.

Experts recommend sticking to the following priority list for survival:

• Immediate rescue. If the building is on fire, get out; if someone is shooting, move to cover. Whatever the danger, move away from it.
• First aid. Check yourself for injuries and give yourself first aid.
• Self-defense. If you are in danger (for example, near predatory animals), you must arm yourself. It can be a stick, a knife or any other object that will allow you to defend yourself.
• Physical needs. Housing, fire, water, food and hygiene.
• Positivity. A positive attitude is the key to emotional endurance.

First Aid

There are three most common injuries that you need to be able to cope with.

Wounds. Minor cuts can be ignored in most cases, as long as the wound is kept clean. If the injury is deep, a tourniquet must be used. The tourniquet is tightened around the limb above the wound in case of arterial bleeding and below the wound in case of venous bleeding.

Fractures and dislocations. In cases with dislocation, a fixation bandage is usually applied. In case of fractures, it is necessary to apply a splint, a pair of sticks will do. The broken bone is first stabilized with sticks and then tied together with cords or ropes.

Burns. In the event of a first-degree (redness) or second-degree (blistering) burn, try to clean the damaged area of ​​dirt (if there is water, rinse), keep the wound elevated and do not open the resulting blisters.

Self Defense

Survival instructors recommend the following approach to predatory animals: face the animal and slowly back away from it. Do not freeze, run or approach the animal. If you find yourself cornered, open your arms and make a lot of noise – there is a chance that the animal will feel threatened and will not attack.

In his book The Emergency, Neil Strauss offers a method of defense against wild dogs that can be applied to other animals in an emergency: in the event of an animal attack, block its mouth with your non-dominant hand and hit it with your other hand in the eyes. The predator will turn off for a while, and you can run away or, for example, climb a tree.

Physical needs

Cover and fire. In any situation, finding/building a shelter is paramount to shelter from the elements. Shelter should protect from external hazards and keep warm. The simplest option is an A-shaped shelter. It is enough to stuff tarps or garbage bags with leaves/grass to form a barrier against rain, cold and wind.

Once the shelter is built, move on to making fire. Firefighters recommend keeping in mind the direction of the wind and the surrounding area: build a fire away from overhanging branches, dry stumps, logs, grass and leaves.

Water and food. Priority – water. Once you find water, boil it if possible. Or build a filter by layering bark, stones, sand and passing water through them. Research edible plants in your area.

How to be saved

Survival experts recommend: if you get lost, stop, think and look around. In most cases, you should stay where you are and wait for help. Build shelter, light a fire and find food. When there is no one to wait for help, you need to move on. If you have a general idea of ​​the area, head to the nearest road. If you don’t know the area, follow the water source downstream or head to a clearing where you can noticeably signal for help.

Hopefully you’ll never need these skills, but even if you don’t plan to go camping, there’s always a chance you’ll get stuck on your trip. Having mastered survival skills, you will be able to get out of most difficult situations. And do not forget to properly charge your mobile phone and take an extra battery before hiking or traveling so you will always be in touch.

Source: 4brain.ru
Image: Yandex.images

How to Freeze an Injured Ankle: 8 Steps (with Pictures)

An injured or sprained ankle can be quite painful and may lie flat for days. In most ankle injuries, the tendons and ligaments of the ankle joint are stretched or stretched. The blood vessels that supply your legs with blood and oxygen also often rupture and leak blood into the surrounding tissues, bruising your ankle and foot. Fortunately, most ankle injuries are not serious and heal on their own after a few days of home treatment. Most minor ankle injuries can be treated at home using rest, ice, and elevation to reduce swelling.

Steps

Part One of 2: Ankle Treatment

1. one Rest the injured ankle as much as possible for 48 hours. After a sprained or injured ankle, it is important to rest the ankle to avoid aggravating the injury. Remain seated or lie down for as long as possible with your ankle elevated. If you have to walk, walk slowly and use a crutch to take some of the weight off your injured ankle. If this is too painful, try putting a brace on your injured ankle so you can move around.

   • It is normal to stay active for the first 48 hours. In fact, moderate activity (such as walking with a crutch) can help strengthen the muscles in an injured ankle.
   • You can buy a corset from a medical supply store. Ankle braces can also be sold at major pharmacies or pharmacies.

2. 2 Place an ice pack on the injured ankle for 15 to 20 minutes. If you don’t have an ice pack handy, try dampening a washcloth and wrapping it around 6-7 ice cubes, or use a bag of frozen vegetables as an ice pack. Choose something with small pieces, such as frozen peas or corn. Then apply an ice pack to your ankle. Lightly apply ice to the injured ankle so that it cools the skin without causing pain.

   • Applying an ice pack to an injured ankle will constrict the blood vessels and restrict blood flow to the injured area, minimizing swelling.
   • Applying ice to an injured ankle has the added benefit of providing pain relief by numbing the nerves in that area.
   • You can buy gel ice packs at a drugstore or pharmacy.

3. 3 Apply ice 4-8 times daily for the first 48 hours after injury. During the first 48 hours, the injured ankle will be swollen and can be quite painful, so ice will help reduce the swelling. As with the original frosting, keep an ice pack on your ankle for 15 to 20 minutes each time. Freeze your ankle when you feel pain or start to swell, or when there is time in your schedule to apply ice.

   • If an ice pack is kept near an injured ankle for more than 20 minutes, frostbite or skin damage may result.

4. 4 Compress the injured ankle for 48 hours to prevent swelling. The best way to compress your ankle is to put your foot on an elastic or neoprene compression sock (or a compression sleeve that wraps around your ankle). The compression sock will put even pressure on the ankle and prevent swelling after injury. If you don’t have access to a compression sock, you can use an elastic band or bandage instead.

   • You can buy a compression sleeve or sock at most pharmacies and pharmacies. They will also be available at most sporting goods stores and even some major supermarkets.

5. 5 Raise the injured ankle above the heart to reduce swelling. While at home during the first 48 hours after an ankle injury, spend as much time as possible lying or sitting with the injured ankle elevated. Lie back and place your injured ankle on a pile of pillows or on a chair at the base of the sofa or bed you are lying on. When you bend over, the injured ankle should always be above the level of the heart.

   • When lifting your injured ankle, keep your leg straight. Try not to bend your leg so as not to put pressure on your ankle.

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Part 2 of 2: Dealing with Serious Injury or Pain

1. one Consult your doctor if your ankle does not improve after 2-3 days. If the ankle cannot bear the load or is still swollen after 72 hours, it may be seriously injured. Visit your doctor and describe how the injury occurred, how you treated it, and how much pain you are experiencing. Let the doctor examine the injured ankle. The doctor may also take an x-ray of the ankle to make sure it is not a broken bone.

   • Also see a doctor if you notice red streaks or spots coming out of the injured area. This may be a sign of an infection.

2. 2 Take painkillers with NSAIDs to reduce swelling and reduce pain. Over-the-counter pain relievers such as ibuprofen (Advil) and acetaminophen (Tylenol) can be very helpful in relieving pain during the healing process. They also prevent swelling, which allows the ankle to heal faster. Take the capsules as directed on the package and avoid taking more than 3200 mg of any NSAID daily.

   • You can buy medicines for NSAIDs at any pharmacy or pharmacy.

3. 3 Go to the emergency room if your injured ankle cannot bear the load. Also go to the emergency room if your ankle is completely numb or if you cannot flex your ankle. These are signs of a torn ligament and the ankle may need surgery to repair the bones and ligaments in the ankle. If you can’t drive on your own, ask a friend or family member to drive you or call an ambulance.

   • If your ankle is broken – and especially if any bones protrude from your broken ankle – go to the emergency room immediately.
   • Ankle tingling may indicate that the injured area is not getting enough blood and oxygen. It may also indicate nerve damage.

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Community Q&A

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• Q: How do I treat a sprained ankle? Stretch it regularly to increase your range of motion, put on a compression band if you go outside, and use ice regularly. Doing exercises such as standing on a pillow with a twisted ankle for a minute will strengthen the affected muscle.

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• If you have injured ankle ligaments, it may take several days to recover. Damaged ligaments swell quickly and are usually very painful. The more pain and swelling, the more likely it is to be injured.
• When you injure ankle ligaments, substances called prostaglandins accumulate in the injured area. These substances stimulate pain receptors to send pain signals to the brain and cause swelling in that area by dilating blood vessels to increase blood flow. The more blood flows to the injured area, the more swelling occurs.
• If you have circulation problems, talk to your doctor before applying ice to an injury. Circulatory problems and disorders such as diabetes, peripheral arterial disease (narrowing of the arteries that supply blood to the legs), and Buerger’s disease (narrowing of the blood vessels in the arms and legs) can be made worse if the limb becomes icy.

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