What causes an ankle sprain. How is an ankle sprain diagnosed. What are the most effective treatments for a sprained ankle. How long does it take for an ankle sprain to heal. What rehabilitation exercises are recommended for ankle sprains. How can you prevent future ankle sprains. When should you see a doctor for an ankle sprain.

Understanding Ankle Sprains: Definition and Mechanisms

An ankle sprain occurs when the ligaments in the ankle are stretched or torn, usually due to a sudden twisting motion. This common injury can range from mild to severe, depending on the extent of ligament damage. But what exactly happens when you sprain your ankle?

When you twist your ankle, the ligaments that connect the bones and provide stability are forced beyond their normal range of motion. This stretching or tearing causes immediate pain, swelling, and often bruising. In more severe cases, you may hear or feel a popping sensation as the ligament tears.

Types of Ankle Sprains

• Lateral sprain: Most common, affecting the outer ligaments
• Medial sprain: Less common, involving the inner ligaments
• High ankle sprain: Affects the ligaments connecting the tibia and fibula

Is there a difference in severity between these types? While lateral sprains are the most frequent, high ankle sprains often take longer to heal and may require more extensive treatment.

Common Causes and Risk Factors for Ankle Sprains

Ankle sprains frequently occur during sports and physical activities, but they can happen to anyone during everyday activities. Understanding the common causes can help you take preventive measures.

Sports-Related Causes

• Sudden changes in direction while running
• Landing awkwardly after jumping
• Stepping on another player’s foot during team sports
• Falling or sliding with the foot planted

Non-Sports Related Causes

• Walking on uneven surfaces
• Stepping off a curb incorrectly
• Wearing high heels or unstable footwear
• Tripping or falling

Are some people more prone to ankle sprains than others? Individuals with previous ankle injuries, weak ankle muscles, or poor balance may be at higher risk. Additionally, certain foot structures, such as high arches or flat feet, can increase susceptibility to sprains.

Recognizing the Symptoms of an Ankle Sprain

Identifying the symptoms of an ankle sprain is crucial for proper treatment and recovery. The severity of symptoms often correlates with the extent of the injury.

Common Symptoms

1. Pain, especially when putting weight on the affected foot
2. Swelling
3. Bruising
4. Restricted range of motion
5. Tenderness to touch
6. Instability in the ankle
7. Popping sensation at the time of injury (in severe cases)

Can the severity of a sprain be determined by symptoms alone? While symptoms provide important clues, a proper medical evaluation is necessary to determine the full extent of the injury and guide treatment decisions.

Diagnosing Ankle Sprains: Medical Evaluation and Imaging

Accurate diagnosis of an ankle sprain is essential for appropriate treatment and to rule out other potential injuries, such as fractures. Healthcare providers use a combination of physical examination and, in some cases, imaging studies to assess the injury.

Physical Examination

During a physical exam, your doctor will:

• Ask about the mechanism of injury and your symptoms
• Inspect the ankle for swelling, bruising, and deformity
• Palpate the ankle to check for areas of tenderness
• Test the range of motion and stability of the joint
• Assess the strength and sensation in the foot and ankle

Imaging Studies

Depending on the severity of symptoms and findings from the physical exam, your doctor may recommend:

• X-rays: To rule out fractures or other bone abnormalities
• MRI: For detailed imaging of soft tissues, including ligaments
• Ultrasound: To visualize ligaments and assess their integrity

Are imaging studies always necessary for diagnosing ankle sprains? Not always. In many cases, a thorough physical examination is sufficient for diagnosis. However, imaging may be recommended if there’s suspicion of a more severe injury or if symptoms persist despite initial treatment.

Effective Treatment Strategies for Ankle Sprains

The treatment of ankle sprains aims to reduce pain and swelling, promote healing, and restore function. The approach varies depending on the severity of the sprain.

RICE Protocol

The RICE method is a cornerstone of initial treatment for ankle sprains:

• Rest: Avoid putting weight on the injured ankle
• Ice: Apply cold packs for 15-20 minutes every 2-3 hours
• Compression: Use an elastic bandage to reduce swelling
• Elevation: Keep the ankle raised above heart level when possible

Medications

Over-the-counter pain relievers and anti-inflammatory drugs can help manage pain and swelling:

• Ibuprofen (Advil, Motrin)
• Naproxen (Aleve)
• Acetaminophen (Tylenol)

Physical Therapy

A structured physical therapy program can significantly improve recovery and prevent future injuries. It typically includes:

• Range of motion exercises
• Strength training for ankle and leg muscles
• Balance and proprioception exercises
• Gait training

Bracing and Support

Various types of support can help protect the ankle during healing and return to activities:

• Elastic bandages for compression
• Ankle braces for stability
• Supportive footwear

Surgery

In rare cases of severe sprains or chronic instability, surgical intervention may be necessary. This typically involves repairing or reconstructing damaged ligaments.

How long does it typically take for an ankle sprain to heal? The recovery time varies depending on the severity of the sprain. Mild sprains may heal in a few weeks, while more severe injuries can take several months. Proper treatment and adherence to rehabilitation protocols are crucial for optimal recovery.

Rehabilitation Exercises for Ankle Sprains

Rehabilitation exercises play a vital role in recovering from an ankle sprain and preventing future injuries. A well-designed rehab program helps restore strength, flexibility, and proprioception (awareness of joint position).

Early Stage Exercises

In the initial phase of recovery, gentle exercises can help maintain and improve range of motion:

• Ankle alphabet: Trace the alphabet with your toes
• Gentle ankle rotations
• Towel stretches for the calf and Achilles tendon

Strengthening Exercises

As healing progresses, exercises to strengthen the ankle and surrounding muscles become important:

• Resistance band exercises in all directions
• Calf raises
• Toe raises and curls
• Single-leg stands

Balance and Proprioception Training

Improving balance and proprioception is crucial for preventing future sprains:

• Single-leg balance exercises
• Balance board or wobble board training
• Heel-to-toe walking
• Jumping and landing exercises

When can you start rehabilitation exercises after an ankle sprain? Gentle range of motion exercises can often begin within the first few days after injury, as pain allows. More advanced exercises should be introduced gradually under the guidance of a healthcare provider or physical therapist.

Preventing Future Ankle Sprains: Strategies for Long-Term Ankle Health

While ankle sprains are common, there are several strategies you can employ to reduce your risk of future injuries and maintain ankle health.

Strengthening and Conditioning

Regular exercises to strengthen the ankles and improve balance can significantly reduce the risk of sprains:

• Calf raises and ankle circles
• Balance exercises on stable and unstable surfaces
• Plyometric exercises for athletes

Proper Footwear

Choosing appropriate footwear for your activities can provide crucial support and stability:

• Well-fitting athletic shoes with good ankle support
• Hiking boots for uneven terrain
• Avoiding high heels or unstable shoes when possible

Taping and Bracing

For individuals with a history of ankle sprains or participating in high-risk activities, taping or bracing can provide additional support:

• Athletic tape applied by a trained professional
• Lace-up or hinged ankle braces

Awareness and Technique

Being mindful of your surroundings and using proper technique during physical activities can help prevent sprains:

• Warming up properly before exercise
• Using caution on uneven surfaces
• Learning and practicing proper landing techniques for jumping sports

Can ankle sprains be completely prevented? While it’s impossible to prevent all ankle sprains, especially in high-risk activities, these strategies can significantly reduce your risk and help maintain strong, stable ankles.

When to Seek Medical Attention for an Ankle Sprain

While many ankle sprains can be managed at home, certain signs and symptoms warrant medical evaluation. Knowing when to seek professional help can ensure proper treatment and prevent long-term complications.

Signs You Should See a Doctor

• Severe pain or swelling that doesn’t improve with home treatment
• Inability to bear weight on the affected foot
• Visible deformity of the ankle
• Numbness or tingling in the foot
• Pain in areas other than the ankle, such as the foot or lower leg
• Recurrent ankle sprains or persistent instability

What to Expect at Your Doctor’s Visit

When you see a healthcare provider for an ankle sprain, they will likely:

1. Take a detailed history of the injury and your symptoms
2. Perform a physical examination of your ankle and foot
3. Order imaging studies if necessary
4. Provide a diagnosis and treatment plan
5. Refer you to a specialist or physical therapist if needed

How urgently should you seek medical care for a suspected ankle sprain? If you’re unsure about the severity of your injury or if you have any of the signs mentioned above, it’s best to seek medical attention within 24-48 hours. For severe pain, inability to walk, or suspected fractures, immediate care at an emergency department may be necessary.

Understanding ankle sprains, their causes, symptoms, and treatment options is crucial for anyone who has experienced this common injury or wishes to prevent it. By following proper treatment protocols, engaging in rehabilitation exercises, and implementing preventive strategies, you can promote optimal healing and reduce the risk of future sprains. Remember, while many ankle sprains can be managed at home, don’t hesitate to seek medical attention if you’re concerned about the severity of your injury or if symptoms persist despite home care.

Ankle Sprain | Michigan Medicine

Topic Overview

What is an ankle sprain?

Most people have twisted an ankle at some point in their life. But if your ankle gets swollen and painful after you twist it, you have most likely sprained it. This means you have stretched and possibly torn the ligaments in your ankle.

Even though ankle sprains are common, they are not always minor injuries. Some people with repeated or severe sprains can develop long-term joint pain and weakness. Treating a sprained ankle can help prevent ongoing ankle problems.

What causes ankle sprains?

Most types of ankle sprains happen when you make a rapid shifting movement with your foot planted, such as when you play soccer or get tackled in football. Often the ankle rolls outward and the foot turns inward. This causes the ligaments on the outside of the ankle to stretch and tear. Less often, the ankle rolls inward and the foot turns outward. This damages the ligaments on the inside of the ankle.

An ankle sprain can range from mild to severe, depending on how badly the ligament is damaged and how many ligaments are injured. With a mild sprain, the ankle may be tender, swollen, and stiff. But it usually feels stable, and you can walk with little pain. A more serious sprain might include bruising and tenderness around the ankle, and walking is painful. In a severe ankle sprain, the ankle is unstable and may feel “wobbly.” You can’t walk, because the ankle gives out and may be very painful.

What are the symptoms?

With most sprains, you feel pain right away at the site of the tear. Often the ankle starts to swell immediately and may bruise. The ankle area is usually tender to touch, and it hurts to move it.

In more severe sprains, you may hear and/or feel something tear, along with a pop or snap. You will probably have extreme pain at first and will not be able to walk or even put weight on your foot. Usually, the more pain and swelling you have, the more severe your ankle sprain is and the longer it will take to heal.

How is an ankle sprain diagnosed?

Your doctor will ask you how the injury occurred and if you have hurt your ankle before. He or she will check your foot and ankle, your lower leg, and even your knee to see if you are hurt anywhere else.

In some cases, the doctor may order X-rays to be sure there is not a broken bone in the ankle or the foot.

How is it treated?

In many cases you can first use the RICE approach to treat your ankle:

• R est. You may need to use crutches until you can walk without pain.
• I ce. For at least the first 24 to 72 hours or until the swelling goes down, apply an ice pack for 10 to 20 minutes every hour or two during the day. Always keep a thin cloth between the ice and your skin, and press the ice pack firmly against all the curves of the affected area.
• C ompression. An elastic compression wrap, such as an ACE bandage, will help reduce swelling. You wear it for the first 24 to 36 hours. Compression wraps do not offer protection. So you also need a brace to protect your ankle if you try to put weight on it.
• E levation. Raise your ankle above the level of your heart for 2 to 3 hours a day if possible. This helps to reduce swelling and bruising.

If you are not taking any prescription pain relievers, you may want to take an over-the-counter pain reliever such as ibuprofen or naproxen to reduce pain and swelling.

Proper treatment and rehabilitation (rehab) exercises are very important for ankle sprains. If an ankle sprain does not heal right, the joint may become unstable and may develop chronic pain. This can make your ankle weak and more likely to be reinjured. Before you return to sports and other activities that put stress on your ankle, it’s a good idea to wait until you can hop on your ankle with no pain. Taping your ankle or wearing a brace during exercise can help protect your ankle. Wearing hiking boots or other high-top, lace-up shoes for support may also help. But use caution. Don’t force your foot into a boot if you feel a lot of pain or discomfort.

If your ankle is still unstable after rehab, or if the ligament damage is severe, your doctor may recommend surgery to repair the torn ligaments.

What kind of rehabilitation program should you follow?

Rehab exercises can begin soon after the injury. You can try to walk or put weight on your foot. You may need to use crutches until you can walk without pain. Depending on your pain, you can also begin range-of-motion exercises while you have ice on your ankle. These exercises are easy to do—you just trace the alphabet with your toe. This helps the ankle move in all directions.

Ask your doctor about other rehab. Stretching, strength training, and balance exercises may help the ankle heal totally and may prevent further injury.

Cause

Ankle sprains occur when ligaments that connect the bones in the foot, ankle, and lower leg stretch or tear. There are different types of ankle sprains.

An inversion injury, the most common cause of ankle sprains, occurs when the ankle rolls outward and the foot turns inward. It results in stretching and tearing of the ligaments on the outside of the ankle.

In an eversion injury, the ankle rolls inward and the foot turns outward, damaging the ligaments at the inside of the ankle.

In a “high” ankle sprain, a less common type of injury, ligaments that join the two lower leg bones together above the ankle, called the syndesmosis, are injured. This usually happens if the foot is forced up, or if the leg is forcefully twisted while the foot is planted. This injury can occur either by itself or with an inversion or eversion sprain. If the ligaments of the syndesmosis are injured, the sprain is more severe and takes longer to heal.

Damage to the ligament varies from simply stretched or slightly torn to completely torn. Your doctor will grade your sprain accordingly.

• Grade I is stretching or slight tearing of the ligament with mild tenderness, swelling, and stiffness. The ankle feels stable, and it is usually possible to walk with minimal pain.
• Grade II is a larger but incomplete tear with moderate pain, swelling, and bruising. The ankle sometimes feels stable, but the damaged areas are tender to the touch, and walking is painful.
• Grade III is a complete tear of the affected ligament or ligaments with severe swelling and bruising. The ankle is unstable and may feel “wobbly.” Walking is usually not possible, because the ankle gives out and there is intense pain, although initial pain may quickly subside.

Symptoms

People usually feel immediate pain at the site of an ankle sprain. Often the ankle starts to swell immediately and may develop bruising. The affected area is usually tender to touch and may feel “wobbly” or unstable.

In a mild sprain, swelling usually goes down within a few days.

The severity of your symptoms usually depends on how much tearing has occurred. In more severe sprains, you are often not able to walk or even put weight on your foot, and your ankle may feel unstable. You usually have extreme pain at first, but some people start to feel better fairly soon. You may also hear and/or feel a tearing sensation and a pop or a snap.

If a sprain does not heal correctly, your ankle joint may be more likely to be injured again or the pain may not go away. This often occurs with even a slight trauma, such as stepping off a curb or walking on uneven pavement. Some people complain of persistent pain and swelling.

When to Call a Doctor

Call your doctor now or seek immediate medical care if:

• Your pain is getting worse.
• Your swelling is getting worse.
• Your splint feels too tight or you are unable to loosen it.

Watch closely for changes in your health, and be sure to contact your doctor if you are not getting better after 1 week.

If your pain is mild and you are able to put some weight on your foot, you may follow the recommendations in the Treatment Overview and Home Treatment sections of this topic. Early treatment followed by rehabilitation exercises help your ankle heal properly. If treatment recommendations are not followed, your ankle may stay weak and unstable.

Who to see

For evaluation, diagnosis, or treatment of an ankle sprain, you may see:

For further treatment, you may be referred to:

Exams and Tests

Your doctor will ask you when and how the ankle sprain occurred and ask about any prior injuries.

Next, your doctor will examine your foot, ankle, and lower leg and even your knee to see if any other injury occurred. He or she may ask you to move your foot up and down and to take a few steps if possible. Your doctor will then carefully try moving your foot and ankle to see if the ligaments are intact and what movements cause pain.

If your sprain is mild, an X-ray may not be taken. If your sprain is more severe, you may need X-rays to evaluate the ankle. X-rays can help your doctor find out whether you have any ligament tears, broken bones, or bones that have moved out of their normal positions.

X-rays are often taken for children because of potential injury to the bone’s growth plate and possible disruption of normal growth. Doctors may take X-rays of both ankles so they can compare the injured ankle with the one that is healthy.

Treatment Overview

Initial treatment for an ankle sprain is summarized as the RICE approach:

• R est. You may need to use crutches until walking is not painful without them.
• I ce. For the first 48 to 72 hours or until swelling goes down, apply an ice pack for 10 to 20 minutes every 1 to 2 hours during the day. After 48 hours, you can continue with ice or try contrast baths. There is not good scientific evidence that ice or contrast baths help, but they are often used.
• C ompression. An elastic compression wrap will help decrease swelling and should be worn for the first 24 to 36 hours. A protective brace should also be worn if you try to bear weight on your injured ankle. Don’t apply the wrap too tightly. Loosen the bandage if it gets too tight. Signs that the bandage is too tight include numbness, tingling, increased pain, coolness, or swelling in the area below the bandage. See instructions on how to wrap an ankle with an elastic bandage. Compression wraps do not offer protection, except by reminding you to be careful of your ankle.
• E levation. Raise your ankle above the level of your heart for 2 to 3 hours a day if possible to decrease swelling and bruising.

If you are not taking any prescription pain relievers, you may want to take an over-the-counter pain reliever such as ibuprofen or naproxen to reduce pain and swelling. Be safe with medicines. Read and follow all instructions on the label.

It may help to wear hiking boots or other high-top, lace-up shoes for support. But use caution. Don’t force your foot into a boot if you feel a lot of pain or discomfort.

Your doctor may suggest that you keep some or all of your weight off your ankle as it heals. If this happens, learn to use your crutches or walker properly and safely.

Almost all ankle sprains heal on their own with proper home treatment and rehabilitation (rehab) exercises.

Surgery to repair torn ligaments is usually only considered when there is a severe ligament tear (or tears) or if the ankle remains unstable after rehab. Surgery is also a consideration if you have broken a bone.

Home Treatment

Ankle sprains take an average of 6 weeks to heal but can take can up to 4 months, depending on the severity. An ankle brace, air stirrup, hiking boots, or other form of ankle support should be worn during this time to protect the ligaments. After the ankle is healed, wearing an ankle brace or taping the ankle may help prevent reinjury.

For more painful and severe sprains, you may not be able to walk, although you might be able to bear some weight while using crutches and a protective brace, such as a brace with a built-in air cushion or other form of ankle support. If pain is severe, use crutches until your doctor tells you that you can begin to bear weight. In general, if your pain is bearable, you should try to walk or bear some weight while using crutches and a protective brace, because these activities promote healing.

Some people who have repeated or severe sprains can develop long-term joint pain and weakness. Treating a sprained ankle can help prevent ongoing ankle problems. Rehabilitation (rehab) exercises for an ankle sprain can be done at home to promote proper healing and prevent chronic pain and instability. When rehab exercises are not followed after a sprain, the ankle can become weak and unstable.

In the case of a minor sprain, rehab exercises begin soon after the injury with walking. You can try wearing hiking boots or other high-top, lace-up shoes for support. But use caution. Don’t force your foot into a boot if you feel a lot of pain or discomfort.

Stretching exercises should be continued daily and especially before and after physical activities to prevent reinjury. Even after your ankle feels better, continue with muscle-strengthening exercises and balance and control exercises several times a week to keep your ankles strong.

The timing and type of rehab exercises may vary according to your doctor’s or physical therapist’s preferences. You will probably do the following types of exercise.

• Range-of-motion exercises to move the joint as far as you can in every direction that it moves. You can start these exercises soon after your injury.
• Stretching exercises to keep your Achilles tendon (heel cord) flexible while your ankle heals. You can start stretching as soon as you can do so without pain.
• Strengthening exercises to strengthen the muscles so they help support your ankle. Talk to your doctor or physical therapist about the timing of strengthening exercises for the ankle. In general, you can start these exercises after you are able to stand without increased pain or swelling, as long as you do not feel pain while you do them.
• Balance and control exercises to help your foot and ankle respond to activities, which can help prevent reinjury. You can usually start balance and control exercises when you are able to stand without pain. But talk to your doctor or physical therapist about the exact timing. You should not feel pain while doing these exercises. Also, don’t try these exercises if you could not have done them easily before your injury. If you think you would have felt unsteady doing these exercises when your ankle was healthy, you are at risk of falling when you try them with an injured ankle.

References

Other Works Consulted

• American Academy of Orthopaedic Surgeons and American Academy of Pediatrics (2010). Ankle sprain. In JF Sarwark, ed., Essentials of Musculoskeletal Care, 4th ed., pp. 762–767. Rosemont, IL: American Academy of Orthopaedic Surgeons.
• Giza E, Silvers HJ (2010). Ankle instability prevention. In JC DeLee et al., eds., DeLee and Drez’s Orthopaedic Sports Medicine: Principles and Practice, 3rd ed., vol. 1, pp. 338–341. Philadelphia: Saunders.
• Hertling D, Kessler RM (2006). Lower leg, ankle, and foot. In Management of Common Musculoskeletal Disorders: Physical Therapy Principles and Methods, 4th ed., pp. 559–624. Philadelphia: Lippincott Williams and Wilkins.
• Krabak BJ (2015). Ankle sprain. In WR Frontera et al., eds., Essentials of Physical Medicine and Rehabilitation, 3rd ed., pp. 426–430. Philadelphia: Saunders.
• Mann JA, et al. (2014). Foot and ankle surgery. In HB Skinner, PJ McMahon, eds., Current Diagnosis and Treatment in Orthopedics, 5th ed., pp. 384–455. New York: McGraw-Hill.

Credits

Current as of:
November 16, 2020

Author: Healthwise Staff
Medical Review:
Adam Husney MD – Family Medicine
E. Gregory Thompson MD – Internal Medicine
Kathleen Romito MD – Family Medicine
William H. Blahd Jr. MD, FACEP – Emergency Medicine

Current as of: November 16, 2020

Author:
Healthwise Staff

Medical Review:Adam Husney MD – Family Medicine & E. Gregory Thompson MD – Internal Medicine & Kathleen Romito MD – Family Medicine & William H. Blahd Jr. MD, FACEP – Emergency Medicine

How Long Does a Sprained Ankle Stay Swollen? | PowerRebound™

Sprained ankles are the pits. They can happen to anyone, whether you’re an athlete sprinting toward a goal line or just a regular Joe out going for a leisurely walk a little too close to the curb. As you watch your ankle slowly begin to balloon up, you wonder, “How long does a sprained ankle stay swollen?”

Sprained ankles stay swollen as little as a few days and as long as a few weeks.  Your ankle will stay swollen longer if you have a more severe sprain and if you neglect to treat the ankle diligently.

How Long Does a Sprained Ankle Stay Swollen?

You can expect to have a sprained ankle for at least a few days if not a week.

Swelling and pain are the first signs of a sprained ankle. Sprained ankles do not just happen randomly. They result from some sort of trauma to the joint.

You will know if you’ve injured your ankle. The real question is, how severe is your sprain? The answer to this question will determine how long you can expect your ankle to stay swollen.

Doctors diagnose the severity of a sprained ankle with a three grade system.

Grade 1 Ankle Sprain

Doctors refer to this sprain as a mild sprain. When you overstretch your ligament you will have some slight swelling, pain, and bruising around the joint. You should still be able to put a moderate amount of weight on the ankle.

With a grade 1 sprain, you may even be able to walk with a sprain, unassisted.

Because you did not tear any ligaments or tendons and just stretched them, you will recover more quickly with a grade 1 ankle sprain. With the right treatment, you might find yourself resuming normal activity within a week of the injury.

Grade 2 Ankle Sprain

A grade 2 sprain takes more toll on the body than a grade 1 sprain. Doctors will diagnose the sprain as grade 2 if overstretching the ligament causes a partial tear in it. In the case of a grade 2 sprain, you tore some tissue.

Because you partially tear a ligament with a grade 2 sprain, you will not be able to easily or quickly put weight on your ankle. Your joint will feel wobbly because you’ve compromised the stability of it. Your ankle will swell, bruise, and hurt.

Logically, a grade 2 sprain will have more swelling and a longer period of swelling than a grade 1 ankle sprain. You will need a more diligent and longer-term treatment plan for a grade 2 sprain.

Grade 3 Ankle Sprain

A grade 3 ankle sprain is a severe sprain. This is the one where you feel or even hear a pop in your ankle as you go down. With a grade 3 sprain, you completely tear the ligament holding your ankle joint together.

Because you’ve torn the ligament completely, you will have little to no stability on your ankle.

Perhaps you’ve heard that in some cases a sprain is worse than a break. That is the case with a grade 3 ankle sprain. This type of sprain will take a solid six weeks or more to heal, and you may even end up having to have surgery to repair the torn ligament.

You will not be able to put weight on your ankle without a significant amount of pain. You will have significant swelling, bruising, and pain as you endure the recovery of a grade 3 sprain.

Why Does Your Ankle Swell After a Sprain?

Your ankle swells when you sprain it because you’ve overstretched the ligaments that hold your ankle together. Swelling is the body’s inflammatory response to the injury. To truly understand what happens when you sprain your ankle, we need to go back to the basics of ankle anatomy.

Ankle Anatomy 101

Consider the anatomy of the ankle. Your ankle consists of three bones.

1. Tibia: this is one of your lower leg bones. It forms the inside part of your ankle. So the knob on the inside of your leg is the knob of your tibia.
2. Fibula: this is the other lower leg bone. It forms the outside part of your ankle. The knob on the outside of your ankle is the knob of the fibula.
3. Talus: this is the bone underneath the tibia and fibula.

These three bones, connected with ligaments, control the up and down motion of your foot.

You have another part f the ankle joint that consists of the talus and the calcaneus. The talus is an upper bone in this case and the calcaneus is the lower bone.

The connection between these two bones creates allows for side-to-side motion.

All of these bones are connected with a set of ligaments. Cartilage covers the ends of the bones as well. Tendons connect the bones to the muscles that ultimately control the joint.

What Happens When You Sprain Your Ankle?

When you sprain your ankle, you essentially overextend the joint. You roll your ankle to the outside or inside of your leg, and you stretch and sometimes tear ligaments and tendons that hold the ankle joint together.

The result is an unstable and incredibly painful joint. Your ankle joint will fill with fluid as a result of the trauma to the joint. The fluid could be blood from broken blood vessels or just the fluid of the bursa sacs that cushion and lubricate your bones when you move.

How Do I Know I’ve Sprained My Ankle? 

If you’ve rolled your ankle joint, you most likely have sustained at least a grade 1 sprain. You will not know how bad your sprain is with certainty until you visit a doctor.

If you’re in a significant amount of pain, you can always visit an emergency department or urgent care facility. If you can wait for a clinic visit, then do so. You do not need emergency care for a basic sprained ankle unless you think you’ve suffered a grade 3 sprain.

Your doctor will ask you how you hurt your ankle as well as what your symptoms are. He will want to know if you could stand or walk after you sustained the injury. Many doctors can diagnose a sprained ankle with just basic conversation about how you sustained the injury and what your symptoms were afterward.

Sometimes a doctor will use a more technical diagnostics procedure. They may order an X-ray if you cannot walk more than four or five steps or if your bone is tender. They may also order an ultrasound scan or MRI to see if you have stretched or torn your ligaments.

Sprained Ankle Symptoms

You can diagnose a basic sprain on your own if you know the symptoms of a sprained ankle. They’re pretty basic.

• Swelling: If your ankle begins to swell to a point that you can no longer see the bone, you may have sprained your ankle.
• Bruising: If you’ve sprained your ankle, you will see significant bruising. You may not see it immediately, but within a day it will develop. You will see purple and deep blue blotches around the ankle bone.
• Pain: Sprained ankles are painful. You will have mild to severe pain, especially when you attempt to put weight on your ankle.
• Unsteadiness: Your ankle ligaments hold your ankle joint together. When you overstretch those ligaments, you loose the joint, creating an unsteady footing. If you feel like the joint is loose or you’re unsteady on your feet, you may have sprained your ankle.

Be aware of these symptoms even before you go into the doctor. They will ask you about them specifically. Being ready with answers will allow your doctor to come up with a thorough diagnosis and effective treatment plan.

What Can I Do to Reduce Swelling?

Swollen ankles look unsightly and feel uncomfortable even when you don’t have a sprain. You can provide yourself with some swollen ankle relief by slowing down and doing these things regularly.

Begin with the RICE method of treatment.

Rest

If you’ve sprained your ankle, you’re most likely already a fairly active person. Latent people do not sprain their ankles. Your status as an active person makes this first step all the more important.

Take time to rest. Do not muscle through the pain to do one more thing for one more person. Do not attempt to go out and keep running or walking through the discomfort.

Sit down. Do not put more weight on your foot. The more you take this first step seriously, the more quickly you’ll be back to your routine, and the more quickly your swelling will go down.

Ice

As you rest, use cold therapy to reduce your swelling. This means you need ice or an ice pack or an ice bath to see your swelling reduce quickly.

Ice has proven to reduce inflammation in an injured joint. Big, flexible ice packs work nicely because they can form to the joint you’re attempting to treat.

For an ankle, though, you can do better.

Get a large bucket, like a five-gallon pail. Fill it with cold water and a small bag or a few trays of ice. Then immerse your foot in the water for ten to fifteen minutes at a time.

This treatment will help you see your swelling go down quickly because you’re hitting every part of the joint with anti-inflammatory cold treatment. This is also a pretty uncomfortable treatment, but it is incredibly effective.

Compression

Once you’ve iced your foot, you need to compress it. Use an ace bandage or a compression sleeve made specifically for ankles. Compression will help your swelling stay down after you’ve iced your ankle.

Compression also helps stabilize the joint. You’ve overstretched the ligaments, so your joint can easily go out of place again. A compression wrap or brace will keep your joint in line as you work on walking again.

Elevate

As you rest, put your feet up. Elevate your injured ankle above your heart.

When you elevate your foot, the fluid from your swollen ankle will flow down, and you’ll see your swelling reduced. Plus, you’ll have to rest because no one can be active with their ankle above their head.

Elevation has proven to be so effective, runners who do not have injuries will engage in it after they run. When an endurance runner spends an hour on their feet, they’ll use “leg drains” as a way to recover more quickly and reduce the swelling that ultimately occurs in their ankles and legs. They sit down with their rear against a wall and their legs above them, with hips at a 90-degree angle.

Elevating your legs is a key to seeing your swelling go down. The pros have proven it. It’s a major way for how to reduce ankle swelling in a sprained ankle.

RICE is a great general way to treat any injury. With an ankle sprain, you can treat the injury according to the grade of sprain you sustained.

Things to Avoid

The things you do like RICE will help you recover quickly. They’re the best answer in how to treat a swollen ankle. You can avoid certain activities as well to help you regain mobility.

• Avoid heat. Stay away from hot baths or heat packs immediately after an injury.
• Avoid alcohol. Alcohol slows down your recovery and also impairs your judgment. It can affect your ability to stay well.
• Avoid running. Running junkies listen up. You cannot run on a sprained ankle. You need to let it heal completely before you run on it.
• Avoid massage. Do not massage your injury. This will only increase bruising and swelling within the first few days after the injury. Just rest, ice, compress, and elevate.

Fat Ankles Be Gone

Swollen ankles stink right up there with the sprain that causes them. If you’re patient and treat your ankle right, you will see your swelling go down and your mobility return.

How long does a sprained ankle stay swollen? Your treatment of your ankle will ultimately answer this question.

If you have questions about our products, check out our website. We can help you with all of your joint needs.

For the best braces on the market and treatment for joint pain contact us.

Signs and Treatment for Sprained Ankles

Do you have a sprained ankle? Ankle sprains are among the most common injuries. Ankle sprains sprain occur when the ligaments in the ankle are stretched or torn. Ankle sprains can be very painful and incapacitating. If you have an ankle sprain, it’s a good idea to see your podiatrist. Read on to to learn about the signs and treatment for sprained ankles.

Signs You Have a Sprained Ankle

1. Pain: An ankle sprain can be painful and can make it hard to carry out your day-to-day activities. You may also feel discomfort when you place weight on the affected area. The pain may worsen when the area is pressed and during standing or walking.

2. Redness: A sprained ankle can cause warmth and redness around the affected area. If your ankle is warm, red, and swollen, it is inflamed. Warmth and redness is caused by increased blood flow to the area.

3. Swelling: When an ankle is injured with a sprain, inflammation occurs. Swelling is the body’s protective response to an injury. Inflammation occurs because of increased fluid in the tissue. This is a normal reaction of the body and is the start of the healing process. However, sometimes the body produces more swelling that necessary.

4. Bruising: A sprained ankle causes bruising around the affected joint. A contusion, commonly known as a bruise, is made up of blood beneath the skin. A bruise results in a discoloration of the skin. Bruising is a result of injury to the blood vessels in the skin.

5. Stiffness: A sprained ankle causes limited range of motion and stiffness. Inflammation and pain often limit movement after the injury. Your podiatrist may advise against moving the ankle to allow your ankle to heal. Your podiatrist may also design an exercise program to reduce stiffness after the injury.

Treating a Sprained Ankle

1. Rest your ankle: All ankle sprains require a period of rest. Resting your ankle will allow the healing process to begin. Stay off your feet to allow your ankle to heal. Gently exercise your ankle on a regular basis to reduce stiffness. Avoid strenuous activites, such as running and aerobics, until you can walk without it causing any pain.

2. Elevate your ankle: Keep your ankle raised above the level of your chest for several days after injury. Use pillows to keep your foot elevated. Keep your foot elevated for a few hours per day until your ankle stops swelling. Elevation is important after an injury as it helps to reduce the amount of blood flow to the injured area. This helps to reduce the inflammation, bruising, and pain.

3. Ice your ankle: Ice treatment can help decrease pain, swelling, bruising, and muscle spasms. To make an ice pack, fill a freezer bag with ice. Put an ice pack on your injured ankle for 10 minutes every 2 hours. Wrap an elastic medical bandage around the ice pack to hold it in place. You should not use ice for more than 20 minutes at a time. If you have circulation issues or diabetes, talk to your doctor before applying ice.

4. Compress your ankle: Apply a compression bandage from the toes to above the ankle. Wrapping your ankle will help to avoid bruising and swelling. Wrap the bandage around your ankle and foot, and secure it with medical tape. Make sure the bandage doesn’t restrict blood flow to your toes or make the pain worse. Do combine compression with elevationa and rest whenever possible.

5. Take a pain reliever: If you have severe pain, a narcotic pain reliever can make you feel better. An OTC pain reliever may also help reduce the pain and swelling. Most medical professionals recommend anti-inflammatory medicines such as naproxen, ibuprofen, or ketoprofen. You can also take acetaminophen for pain, although this medicine does not reduce inflammation. Be safe with medicines. Read and follow all instructions on the label.

6. See a doctor: A podiatrist can diagnose and treat an ankle sprain. Your doctor may order x-rays to determine if you have a broken bone in your ankle. You may receive an ankle brace to keep your ankle from moving and allow ligaments to heal. Your doctor will also give you medications to reduce swelling and pain. Once you can bear weight without increased pain, your doctor will add strengthening exercises to your treatment plan.

Whether your goal is getting back to work, hobbies, sports, the gym, or just enjoying life, a podiatrist can help. If you have an ankle sprain, search for a podiatrist in your area and schedule an appointment. A podiatrist can help you get back on track in no time!

Sprained Ankle | Orthopedics & Sports Medicine

Most ankle sprains need only a period of protection to heal. The healing process takes about four weeks to six weeks. The acronym R.I.C.E is a good way to remember what to do:

• Rest your ankle by not walking on it.
• Ice should be immediately applied. It keeps the swelling down. It can be used for 20-30 minutes, 3-4 times per day.
• Compression dressings, bandages, or ace-wraps immobilize and support the injured ankle.
• Elevate your ankle above your heart level as much as possible for the first 48 hours.

Depending upon the grade of injury, your doctor may recommend a cast boot, air splint, and/or crutches. Even a complete ligament tear can heal without surgical repair if it is immobilized appropriately.

Your doctor may tell you to incorporate motion early in the healing process to prevent stiffness. Even with a chronic tear, your ankle can still be highly functional because overlying tendons help with stability and motion.

Rehabilitation is used to help decrease pain and swelling and prevent chronic ankle problems. Rehabilitation may include:

• Ultrasound
• Electrical stimulation
• Active range of motion exercises or controlled movements of the ankle joint without resistance
• Water exercises if land-based strengthening exercises, such as toe-raising, are too painful.
• Lower extremity exercises and endurance activities as tolerated.
• Proprioception training

Non-steroidal anti-inflammatory drugs (NSAIDs) may be used to control pain and inflammation.

Surgical treatment for ankle sprains is rare. Surgery is reserved for injuries that fail to respond to non-surgical treatment and for persistent instability after months of rehabilitation and non-surgical treatment. Surgical options include:

• Arthroscopy – A surgeon looks inside the joint to see if there are any loose fragments of bone or cartilage, or part of the ligament caught in the joint.
• Reconstruction – A surgeon repairs the torn ligament with stitches or suture, or uses other ligaments and/or tendons found in the foot and around the ankle to repair the damaged ligaments.

Why Won’t My Ankle Sprain Heal?

Suneel K. Basra, DPM, FACFAS

Foot & Ankle Surgeon from New Jersey

As foot and ankle surgeons, we see it happen all the time—one minute a person is walking, the next, they misstep and “twist” their ankle, landing them on the ground and eventually into our offices. Sprained ankles are painful and can temporarily limit a patient’s ability to walk normally, but properly diagnosing and treating an ankle injury in a timely manner is imperative to proper healing and reduces the chances of long-term, chronic ankle pain.

I often hear the misconception from people that, “it’s just a sprain, no big deal,” but sometimes a sprain can be or become more of an issue. Upon examination and after diagnostic tests, such as x-rays and even possibly an MRI, ankle sprains are graded based on severity and location of the injury to the ankle structures. Grade one is least severe—an injury to the outer ankle ligament only. Grade two is an injury to both outer and inner ligaments. Grade three is what is known as a “high ankle sprain”—an injury to the ligament connecting the shin bone to the outer bone of the leg.  

Severity of the injury comes into play as well. Foot and ankle surgeons determine if the ligament is partially or fully torn or overstretched, and we also look to identify how much swelling is going on. Is there a broken bone or a dislocation of the joint? These factors play a role in how we aim to treat the injury and how long the recovery will last.

A bone fracture typically takes six to eight weeks to heal, while a ligament sprain can take between three and six months to heal. The time difference in healing a bone versus a ligament is all about blood flow. The bone has better access to blood, whereas unfortunately, ligaments do not.

Most ankle injuries—roughly 80 percent of cases—require no surgical intervention. Foot and ankle surgeons will always choose the most conservative treatment for the best long-term outcomes for a patient. If just the outer ligament is injured, we can typically reduce pain and swelling with a combination of ice, wraps and rest to lessen the chance of further tearing the ligament.

The other 20 percent of patients might have initially neglected their injury, and because they did not seek immediate care, what began as a grade one, may have turned into a more severe grade two or three injury, possibly requiring surgery.

Sprains not adequately rehabilitated, untreated or repeat injuries can cause chronic ankle instability—a condition marked by persistent discomfort and a giving way of the ankle from stretched or torn ligaments. Proper rehabilitation and treatment are needed to strengthen the muscles around the ankle and retrain the tissues within the ankle that affect balance to help prevent further sprains or injuries. Surgery is sometimes also needed depending on the degree of instability or the lack of response to nonsurgical approaches.

When asked “why my ankle sprain won’t heal,” the simple answer is this: it will heal. It takes time, patience and following your doctor’s instructions. The best thing a patient can do is to be seen by someone who specializes in foot and ankle care as soon as an injury occurs.

For more information on ankle sprains, other foot conditions, or to find a foot and ankle surgeon near you, visit FootHealthFacts.org—the American College of Foot and Ankle Surgeons’ patient education website.

Suneel K. Basra, DPM, FACFAS, is a foot and ankle surgeon from New Jersey. He is board certified in both foot surgery and reconstructive rearfoot and ankle surgery by the American Board of Foot and Ankle Surgery. Dr. Basra holds a podiatric medical degree from the New York College of Podiatric Medicine in New York City. He completed his residency as chief resident at New York Methodist Hospital in Brooklyn, NY. He is also a frequent lecturer and instructor.

Anatomy of an ankle sprain

An ankle sprain occurs when the strong ligaments that support the ankle stretch beyond their limits and tear. Ankle sprains are common injuries that occur among people of all ages. They range from mild to severe, depending upon how much damage there is to the ligaments.

One of the most common knee injuries is an anterior cruciate ligament sprain or tear.

Athletes who participate in high demand sports like soccer, football, and basketball are more likely to injure their anterior cruciate ligaments.

Anatomy of an Ankle Sprain

An ankle sprain occurs when the strong ligaments that support the ankle stretch beyond their limits and tear. Ankle sprains are common injuries that occur among people of all ages. They range from mild to severe, depending upon how much damage there is to the ligaments.

Most sprains are minor injuries that heal with home treatments like rest and applying ice. However, if your ankle is very swollen and painful to walk on — or if you are having trouble putting weight on your ankle at all, be sure to see your doctor.

Without proper treatment and rehabilitation, a more 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 ongoing instability.

Description

Ligaments are strong, fibrous tissues that connect bones to other bones. The ligaments in the ankle help to keep the bones in proper position and stabilize the joint.

Most sprained ankles occur in the lateral ligaments on the outside of the ankle. Sprains can range from tiny tears in the fibers that make up the ligament to complete tears through the tissue.

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 of the ankle joint.

Cause

Your foot can twist unexpectedly during many different activities, such as:

• Walking or exercising on an uneven surface
• Falling down
• Participating in sports that require cutting actions or rolling and twisting of the foot—such as trail running, basketball, tennis, football, and soccer
• During sports activities, someone else may step on your foot while you are running, causing your foot to twist or roll to the side.

Symptoms

A sprained ankle is painful. Other symptoms may include:

• Swelling
• Bruising
• Tenderness to touch
• Instability of the ankle—this may occur when there has been complete tearing of the ligament or a complete dislocation of the ankle joint

If there is severe tearing of the ligaments, you might also hear or feel a “pop” when the sprain occurs. Symptoms of a severe sprain are similar to those of a broken bone and require prompt medical evaluation.

Doctor Examination

Physical Examination

Your doctor will diagnose your ankle sprain by performing a careful examination of your foot and ankle. This physical exam may be painful.

• Palpate. Your doctor will gently press around the ankle to determine which ligaments are injured.
• Range of motion. He or she may also move your ankle in different directions; however, a stiff, swollen ankle usually will not move much.

  If there is no broken bone, your doctor may be able to tell the severity of your ankle sprain based upon the amount of swelling, pain, and bruising.

Imagine Tests

X-rays. X-rays provide images of dense structures, such as bone. Your doctor may order x-rays to rule out a broken bone in your ankle or foot. A broken bone can cause similar symptoms of pain and swelling.

Stress x-rays. In addition to plain x-rays, your doctor may also order stress x-rays. These scans are taken while the ankle is being pushed in different directions. Stress x-rays help to show whether the ankle is moving abnormally because of injured ligaments.

Magnetic resonance imaging (MRI) scan. Your doctor may order an MRI if he or she suspects a very severe injury to the ligaments, damage to the cartilage or bone of the joint surface, a small bone chip, or another problem. The MRI may not be ordered until after the period of swelling and bruising resolves.

Ultrasound. This imaging scan allows your doctor to observe the ligament directly while he or she moves your ankle. This helps your doctor to determine how much stability the ligament provides.

Grades of Ankle Sprains

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 Sprain (Mild)

• Slight stretching and microscopic tearing of the ligament fibers
• Mild tenderness and swelling around the ankle

Grade 2 Sprain (Moderate)

• Partial tearing of the ligament
• Moderate tenderness and swelling around the ankle
• If the doctor moves the ankle in certain ways, there is an abnormal looseness of the ankle joint

Grade 3 Sprain (Severe)

• Complete tear of the ligament
• Significant tenderness and swelling around the ankle
• If the doctor pulls or pushes on the ankle joint in certain movements, substantial instability occurs

In a Grade 2 sprain, some but not all of the ligament fibers are torn. Moderate swelling and bruising above and below the ankle joint are common.

Treatment

Almost all ankle sprains can be treated without surgery. Even a complete ligament tear can heal without surgical repair if it is immobilized appropriately.

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

• Phase 1 includes resting, protecting the ankle and reducing the swelling.
• Phase 2 includes restoring range of motion, strength and flexibility.
• Phase 3 includes maintenance exercises and the gradual return to activities that do not require turning or twisting the ankle. This will be followed later by being able to do activities that require sharp, sudden turns (cutting activities)—such as tennis, basketball, or football.

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.
• Ice should be immediately applied to keep the swelling down. It can be used for 20 to 30 minutes, three or four times daily. Do not apply ice directly to your skin.
• Compression dressings, bandages or ace-wraps will immobilize and support your injured ankle.
• Elevate your ankle above the level of your heart as often as possible during the first 48 hours.

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.

Nonsurgical Treatment

Some sprains will require treatment in addition to the RICE protocol and medications.

Crutches. In most cases, swelling and pain will last from 2 to 3 days. Walking may be difficult during this time and your doctor may recommend that you use crutches as needed.

Immobilization. During the early phase of healing, it is important to support your ankle and protect it from sudden movements. For a Grade 2 sprain, a removable plastic device such as a cast-boot or air stirrup-type brace can provide support. Grade 3 sprains may require a short leg cast or cast-brace for 2 to 3 weeks.

Your doctor may encourage you to put some weight on your ankle while it is protected. This can help with healing.

Physical therapy. Rehabilitation exercises are used to prevent stiffness, increase ankle strength, and prevent chronic ankle problems.

• 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 you can bear weight without increased pain or swelling, exercises to strengthen the muscles and tendons in the front and back of your leg and foot will be added to your treatment plan. Water exercises may be used if land-based 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 may be added, such as agility drills. 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.

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 after months of rehabilitation and nonsurgical treatment.

Surgical options may 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.
• Reconstruction. Your doctor may be able to repair the torn ligament with stitches or sutures. In some cases, he or she 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

Immobilization. There is typically a period of immobilization following surgery for an ankle sprain. Your doctor may apply a cast or protective boot to protect the repaired or reconstructed ligament. Be sure to follow your doctor’s instructions about how long to wear the protective device; if you remove it too soon, a simple misstep can re-tear the fixed ligament.

Rehabilitation. Rehabilitation after surgery involves time and attention to restore strength and range of motion so you can return to pre-injury function. The length of time you can expect to spend recovering depends upon the extent of injury and the amount of surgery that was done. Rehabilitation may take from weeks to months.

Outcomes

Outcomes for ankle sprains are generally quite good. With proper treatment, most patients are able to resume their day-to-day activities after a period of time.

Most importantly, successful outcomes are dependent upon patient 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 continued 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. It can be hard for patients to tell if a sprain has healed because even an ankle with a chronic tear can be highly functional because overlying tendons help with stability and motion.

If pain continues for more than 4 to 6 weeks, you may have a chronic ankle sprain. Activities that tend to make an already sprained ankle worse include stepping on uneven surfaces and 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. There may be imbalance and muscle weakness that causes a reinjury. If you sprain your ankle over and over again, a chronic situation may persist with instability, a sense of the ankle giving way, and chronic pain. This can also happen if you return to work, sports, or other activities before your ankle heals and is rehabilitated.

Prevention

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
• Pay careful attention when walking, running, or working on an uneven surface
• Wear shoes that are made for your activity
• Slow down or stop activities when you feel pain or fatigue

BoulderCentre can help. Call us (303) 449-2730 and ask to see one of our foot and ankle specialists.

Article courtesy of AAOS: American Academy of Orthopedic Surgeons.

Orthopaedic Urgent Care, Sports Medicine & Wellness Clinics

“Oh, I didn’t twist it that bad…”

That’s something we often hear as orthopedic specialists, but the truth is, no matter how slight an ankle sprain, there’s still potential for long-term injury and instability. 

You wouldn’t let a head cold go untreated — give your ankles the same care and visit Dr. Leah Brown here at Urgently Ortho when you’ve sprained your ankle. Otherwise, you could be looking at a lifelong struggle with inflexibility and chronic pain. 

How do you sprain your ankle? 

You can sprain your ankle doing just about anything — even while merely walking if you catch your foot on a ledge and twist your ankle. However, most people sprain their ankles while doing some sort of recreational activity, such as hiking or rollerblading, or while playing a sport. 

You may have referred to a sprained ankle as a “twisted” ankle or a “rolled” ankle, and you wouldn’t be wrong for using those terms interchangeably. When you sprain your ankle, your ligaments get stretched too far because they were suddenly twisted or pulled sideways. 

Symptoms of a sprained ankle

The first sign of a sprained ankle is simple: pain. 

Right after an injury, you’ll likely feel mild-to-severe discomfort, and you may have trouble walking. Pain from a sprained ankle is usually persistent — it won’t just go away on its own in a few hours or by the next day.  

Other symptoms of a sprained ankle include: 

• Swelling of your ankle joint
• Bruising or discoloration around your ankle and on your foot
• Difficulty bending and rotating your foot
• Instability or a “loose” feeling in your ankle

The severity of your symptoms depends on the severity of the sprain, but generally, an ankle sprain leads to discomfort that restricts your basic ability to walk. 

What happens if you don’t treat a sprained ankle? 

With any injury — even a minor one — you stand the risk of long-term complications if you don’t treat it properly. A sprained ankle can turn into a serious chronic instability if left untreated. When you leave torn ligaments to heal on their own, they can fuse together haphazardly and form weak, inflexible scar tissue. 

Your range of motion can suffer tremendously, resulting in difficulty walking for the long term. You may also end up with chronic inflammation as your body continuously attempts to heal an injury that was never properly treated. Additionally, you may experience low-grade chronic pain. 

How to keep your sprained ankle from becoming worse

First things first: PRICE. The PRICE method should be the first line of defense against an ankle sprain, and it’s something you can do at home while you make a doctor’s appointment for an evaluation: 

• Protection: Stabilize your ankle and get to an area free of fall hazards
• Rest: Sit or lie down and keep your weight off of your ankle
• Ice: Put ice on your ankle
• Compression: Wrap your ankle with a tight compression bandage
• Elevation: Rest your ankle so that it sits higher than your hips

After you’ve taken these cautionary tactics, contact Urgently Ortho, or just come in to the clinic, so Dr. Brown can take a look at your sprain. She’ll assess your pain, ask you how you twisted your ankle, and develop a treatment plan for you.  

It’s important to rest your ankle and keep it stabilized. Dr. Brown may also prescribe anti-inflammatory pain medicine and give you a brace, depending on how severe your sprain is. 

Icing your ankle at home and wrapping it in a compression bandage can reduce fluid retention and swelling. 

If you live in or around Scottsdale, Arizona, and think you may have sprained your ankle, call Urgently Ortho right away or request an appointment online. We’re open seven days a week, and we welcome walk-ins. 

90,000 How to treat a swollen ankle?

Long-term treatment for a swollen ankle should depend on what is causing the inflammation. There are several reasons why ankles can swell. This could be a sign that an ankle sprain has occurred, or it could be a symptom of a broken bone in the leg or ankle. It may also indicate other types of ankle injury, or the ankle may be swollen due to water retention or edema. There are some guidelines for the initial treatment of a swollen ankle, as well as some guidelines for when expert treatment and diagnosis should be made.

Sometimes the ankle is swollen and the swelling can be dramatic. There may or may not be pain associated with the tumor. If pain is present, it can hurt the most when weight is placed on the leg or when the foot is moved. Pain that occurs even when there is no weight on the ankle speaks of things like a fracture or severe sprain. Many times people are well aware of how they could get hurt, but sometimes the ankle swells up for no apparent reason, and people suddenly notice significant swelling in the ankle area.

The first step in treating your swollen ankle and determining what to do is to get off your feet. If possible, lie on the floor, sofa, or other and place one or two pillows under your feet. Use ice on the swelling for 15–20 minutes to see if it reduces the swelling, unless the pain is severe enough to cause nausea or shock, or there is no clear sign of displacement of bone or bone emerging through the skin. If these conditions exist, people should see a doctor or emergency department immediately.

When vague and severe pain is the cause, or the conditions above are not present, take time to examine both legs. Look for several things, such as signs of an insect or reptile bite, that could indicate an allergic reaction or contact with a venomous snake. In any of these conditions, symptoms can progress rapidly and people should seek immediate medical attention. Also, note that both ankles are swollen, which may indicate water retention.

After lifting the swollen ankle and icing, determine if the swelling is better, worse, or the same. If both ankles are not swollen, it is best to see a doctor, especially if the ankle is painful. In fact, it’s a good idea to see a doctor when someone else is icy and your foot is up. In many cases, if an ankle injury is suspected, doctors want to look at it and possibly use an X-ray to determine if there is a fracture or sprain. It is not always possible from the outside to determine what injuries could have occurred.

For double ankle edema, which involves water retention, it is also important to consult a doctor. This could be a sign of an emerging medical condition, could indicate kidney problems, which in turn could be a sign of heart problems, or could be symptoms of other things. Provided that the swelling decreases as it increases and is absent in other parts of the body, this does not necessarily mean a medical emergency, but it is still advisable for people to at least call a doctor, describe their symptoms, and let the doctor determine the best course of treatment.

Sometimes when doctors are contacted, they tell people to wait a day to see if their symptoms improve. While waiting, people may want to keep using ice every three to four hours, stay with a swollen ankle, and try to keep it up. A compression or stabilizing bandage may or may not be a good idea. This can sometimes cause more swelling or, if the ankle is enlarged, it can create too much pressure. If a stabilizing dressing is used, check it every few hours to make sure it is not compressing the skin in an uncomfortable way.

OTHER LANGUAGES

Ankle sprain – a directory of diseases – HealthInfo

Treatment depends on the severity of the sprain. Usually, for mild sprains, an elastic bandage is applied to the ankle and foot, ice packs are applied to the injured area, the ankle joint is lifted, and as the injury heals, physical activity is gradually increased, including the length of walking. For sprains of moderate severity, a splint is applied for up to 3 weeks.This allows the person to lean on the fixed injured ankle. For severe sprains, surgery may be necessary. True, the question of the operation is controversial: some surgeons believe that surgical repair of severely damaged and torn ligaments has no advantages over conservative treatment. Before a person returns to normal activity, physical therapy is prescribed to restore movement, strengthen muscles, and improve balance and response.

Occasionally, moderate or severe sprains cause joint dysfunction even after the ligament has healed. A small nodule can form in one of the ankle ligaments that causes constant friction in the joint, leading to chronic inflammation and ultimately irreversible damage. Administration of a mixture of corticosteroids to reduce inflammation and a local anesthetic to reduce pain into the ankle often results in improvement. Surgery is rarely required.

Stretching sometimes damages a nerve that runs over one of the ankle ligaments.This causes pain and a tingling sensation (neuralgia). In such cases, it helps, sometimes for a long time, the introduction of a local anesthetic.

Ankle sprain can be gait-related and is caused by overloading the tendon (the strong, flexible tissue that connects muscles and bones or muscles together) on the outside of the ankle. The result is inflammation and a condition called peroneal tendovaginitis. Constant swelling and soreness appears on the outside of the ankle.In such cases, it is recommended to wear an ankle brace, which limits movement in the ankle joint. Cortisol injections into the tendon sheath can also be effective, but should not be overused.

Occasionally, with severe sprains, the blood vessels of the ankle joint spasm and the blood supply to the ankle is disrupted. As a result, serious damage to bone and other tissues can occur. This condition is called reflex sympathetic dystrophy or Zudeck’s atrophy and is accompanied by swelling and soreness of the foot.Pain, often severe, can migrate up the ankle and foot. Despite the pain, a person must definitely walk. Physiotherapy and oral analgesics can help reduce pain. Constant intense pain is relieved by injecting local anesthetics (nerve block) and corticosteroids into the area of ​​the nerve supplying the ankle joint. In addition, psychological counseling helps.

It happens that after stretching there is constant pain in the area between the calcaneus and the talus.This condition is called tarsal sinus syndrome and may be due to a partial rupture of the deep ligaments of the foot. In these cases, injections of corticosteroids and local anesthetics help.

Running ankle injuries and ankle protection

All it takes to get out of your regular training routine for 6 months is the awkward stumbling on some root or rock while enjoying the views of nature. However, for urban runners, this is also true, albeit to a slightly lesser extent.

Any unevenness on the track poses a potential danger to our ankle joints. Indeed, after a normal sprain, the ankles remain a weak link for about half a year and you will have to seriously adjust your training program for a trail or marathon.

According to statistics, approximately 90,038 10-20% of 90,039 of all sports injuries are ankle sprains. Accordingly, in swimming, this percentage tends to zero, and in sports related to running and jumping, it probably exceeds the same twenty percent.

Skiers have the same possible problem, but it is associated with the rotation of the foot due to sudden braking or unsuccessful entry into a turn. The danger is added by a large lever, the role of which is played by the ski.

Device

This frequency of injury is due to the peculiarities of the anatomical structure and functions of the ankle joint. It is formed by three bones – large , tibia and talus foot bone.These bones are fixed to each other by 3 groups of ligaments:

1. The first group is internal ligaments between the tibia.
2. The second is the outer and inner layers of the deltoid ligament .
3. And the third – talofibular (anterior and posterior) and calcaneofibular ligaments .

Stretching is not stretching

The outer group of ligaments is most susceptible to injury.Stretching, however, is a misnomer of damage because the ligaments do not have the elasticity we would like.

When the foot is twisted, a banal tear of the connective tissue occurs, and the degree of damage and, accordingly, the recovery time (scarring) depend only on the magnitude of this tear. Fortunately, in most cases, the integrity of the ligament is preserved, and only individual fibers are destroyed.

In some cases, the damage to the ligament is maximal, which is designated as rupture of the ankle ligament and often correlates with severe dislocation or fracture of the joints and even bones.

Test SLB

The British Journal of Sports Medicine reported that failure to pass the one-legged balance (SLB) test more than doubles the risk of ankle injury compared to those who pass the SLB test.

For self-test, you need to stand barefoot on a flat surface on one leg and with your eyes closed for 10 seconds . You need to stand straight, and the raised leg should not touch the supporting one (this is important).If you are not very shaken and the balance is stable, the test is considered successful.

Visual inspection

In most cases, experts associate injuries caused by ankle inversion with the loss of proprioception. Therefore, if your brain at a given moment in time is poorly aware of where the ankle is and what it is doing, then it is difficult for it to determine how it should react. In this case, visual control of the surface and leg movements is indispensable and comes to the fore.

Symptoms

The classic consequence of ankle sprains is pain, the severity of which depends on the severity of the injury and lameness. In the case of a pronounced tear, swelling of the soft tissues and a slight swelling around the ankle appear.

With a complete transverse rupture of the ligaments, along with sharp pain and severe swelling, cyanosis of the skin, hematoma, hemarthrosis (accumulation of blood in the ankle joint cavity) and the inability to move independently appear.Together with these signs, pathological mobility of the foot is noted.

Healing and recovery

There are many options, ranging from vodka (just not inside, but in the form of a compress) and milk with slight stretching, and ending with surgical intervention for rupture.

As practice shows, if there is only a slight sprain of the ligaments, then the best remedy is time and, of course, limiting the load. On average, lameness persists for up to two weeks, after which you can very gently work out the leg with running exercises.

Ice is recommended when pain relief is needed. Non-steroidal anti-inflammatory drugs (NSAIDs) help reduce swelling. But I don’t recommend them unless absolutely necessary.

It is possible to immobilize the ankle with an improvised splint – a plate, bandaged to the lower leg. True, this splint should ideally cover not only the lower leg and ankle, but also the knee.

Prevention

The best option is to use a joint strap or a sports brace when driving on trail tracks.And in any other conditions too.

Another nuance, which is more addressed to novice runners, is the accuracy when using a maximum of cushioning sneakers with a thick sole. Raising the foot high above the ground always reduces stability when landing and increases leverage if the foot is accidentally tucked in.

Trail running shoes are sure to include models with an injury-reducing outsole design that includes elements that stabilize the lateral part of the foot.

Unfortunately, doing physical exercises and gymnastics, contrary to the wishes of various fashionable fitness magazines, will not be able to strengthen the ankle ligaments. Moreover, frequent tears reduce their strength, like Achilles. Therefore, running on tall grass in the forest and at night in the mountains without a lantern is not worth it once again.

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90,000 What to do if your legs are swollen?

It is known that for many, swollen ankles and feet can cause discomfort and pain.This condition is characterized by the accumulation of excess fluid in the tissues of the body. Sometimes the swollen, touch-sensitive areas of the legs can become wider than normal and impair motor function. There are various reasons for this condition, which must be immediately diagnosed by the attending physician, since some edema may indicate the development of serious diseases. Among the most common causes of ankle and foot swelling, experts call ankle injury, pregnancy, congestive heart failure, obesity, osteoarthritis, liver cirrhosis, deep vein thrombosis, etc.

In addition to the visible increase in the volume of the legs, experts note the secondary symptoms of this condition, which must be taken into account when determining the causes of leg edema. Some of these symptoms may include high blood pressure, swelling of the hands or wrists, eyes, weight gain, headaches, etc.

To reduce the severity of swelling of the ankles and feet, experts recommend the methods described below.

1. Decrease in salt intake. It is known that excess salt intake helps to retain water in the body.Excessive amounts often accumulate in the ankles and feet, causing swelling. It is important to note that reducing your intake of salty foods will have a positive effect on your cardiovascular health.

2. Massage. Gently rubbing the swollen area can effectively reduce the severity of swelling in the ankles and feet, since massaging the area improves blood circulation and reduces the risk of inflammatory reactions, which often result from injuries or sprains.

3. Position of the legs. Raising the legs above the level of the head helps to reduce the accumulation of fluid in the legs and ankles. Experts recommend placing a pillow under the lower extremities during sleep.

4. Yoga. Yoga, as you know, helps to normalize metabolism in the body, improve hormonal levels and blood circulation. In addition, yoga is an effective way to increase physical activity, strengthen muscles and develop flexibility, which in turn can relieve symptoms of swollen feet and ankles.

5. Compression knee-highs. The use of special form-fitting socks or knee-high socks can reduce the buildup of fluid in the feet and ankles. Experts recommend paying special attention to the use of such socks by pregnant women.

6. Parsley. According to some reports, parsley has a diuretic effect. By adding parsley to your daily diet, you can increase your natural urine output and thereby reduce the accumulation of excess fluid in your body.

7. Physical activity.It is known that exercise can normalize blood circulation in the body, thereby reducing fluid accumulation in the lower extremities. Experts say that often due to poor functioning of the cardiovascular system, the efficiency of pumping blood from the legs is reduced, which leads to their swelling. Therefore, regular jogging or exercise with legs raised above the level of the heart is very important for those with leg swelling.

8. Grapefruit essential oil.According to some reports, grapefruit oil has anti-inflammatory properties and can be used as an adjunct in the treatment of leg swelling. To achieve the effect, experts recommend adding a few drops of this oil to a warm foot bath or rubbing it directly into swollen areas with cream.

9. Salt baths for feet. Carrying out salt baths for the feet several times a week, according to many experts, helps to reduce the severity of edema, relieve pain and discomfort.

10. Dandelion. Dandelion’s active substances, such as polyphenols, flavonoids and potassium, can increase urine output, thereby flushing excess water from the body before it can accumulate in the legs.

11. Rosehip. The fruits of this plant have a strong diuretic effect. In addition, flowers and leaves contain active substances with anti-inflammatory and antioxidant properties. Therefore, supplementation with rose hips can help reduce the severity of swelling in the legs and ankles.

12. Smoking. Experts say that smoking impairs the functioning of the circulatory system and reduces the efficiency of pumping blood from the limbs of the body. Quitting smoking also reduces the risk of obesity, heart failure, diabetes, and a variety of other causes of swelling in the feet and ankles.

13. Swimming. Swimming can be an effective way to treat swelling of the legs, as this puts stress on the lower limbs and normalizes the work of the cardiovascular system.If other physical activity, such as running, is not possible, swimming may be a more appropriate physical activity for people with leg swelling.

14. Drinking an adequate amount of water. A balanced intake of water and foods containing salt can help normalize urination and fluid levels in the body. Adequate water intake also helps to eliminate toxins and improve the functioning of various body systems.

15.Magnesium. It is known that magnesium deficiency is often observed in elderly people with insulin resistance, metabolic syndrome, coronary heart disease and osteoporosis. In addition, according to some reports, the use of dietary supplements with magnesium has a positive effect on kidney function in people with chronic edema. Experts recommend adding foods high in magnesium to your diet, such as spinach, nuts, whole grains, fish, and avocados.

Based on materials from www.organicfacts.net

90,000 From bruise to fracture: how to distinguish a minor injury from a dangerous one – Crimean newspaper

The international conference “Crimean Traumatological Readings” was held in Koreiz. An event of this level in Crimea was held for the first time.

Not only Crimean and Russian doctors participated in it, but also the best orthopedic traumatologists of Germany, France, Italy and Spain. The reports of the conference were devoted primarily to the most common injuries – fractures and dislocations.We will talk about this today.

Unusual mobility

“You have not a closed, but an open fracture there!” – everyone remembers this phrase from the “Diamond Hand”. But if it is really impossible to distinguish one fracture from another under a plaster cast, then you cannot confuse them in their natural form: with an open fracture, the skin is damaged and the picture is very bloody and terrible. Another thing is a closed fracture and a sprain of the ligaments, dislocation – that can be quite confused. An accurate diagnosis can only be made by a doctor.But even on your own, knowing certain signs, you can try to understand how serious the situation is.

So, with a fracture, and with a sprain, and with a dislocation at the site of injury, pain occurs, it swells (with a fracture much stronger), a bruise appears. But if this is a fracture, then when you try to put pressure on the sore spot or slightly move the injured limb, a crunch is heard – this sound is made by broken bones. A specific crunch is heard immediately at the time of the fracture – another hallmark of this injury.In addition, with a fracture at the site of injury, the skin becomes “marble” (red spots appear on it), plus numbness occurs in the broken arm or leg.

In addition, with a fracture, the broken limb usually takes a strange position – with unusual mobility: a part of the leg or arm moves in a place where it should not move. The joint also acquires a strange appearance during dislocation, but unnatural mobility outside the joint is a symptom characteristic only of a fracture. Sometimes a fracture and dislocation can be confused with a bruise, but with a bruise, the range of motion, as doctors call it, does not decrease.Although both pain and swelling are present.

The first hours are important

Dislocation is a displacement of the articular surfaces in relation to each other. In case of dislocation, the limb is unusually twisted, the damaged joint has an altered shape, any movement and touch causes acute pain. An x-ray is prescribed to confirm the diagnosis. Further – reduction, which is done only by a doctor. It is important to know and remember: a relatively painless reduction is possible only in the first hours after the injury! It is much more difficult to correct a dislocation three or five days ago.And if you stretch out more time, you will need surgical intervention.

Press on the ankle

Sprains most often occur in the ankle joint during a fall or an unsuccessful turn. However, with the same input, ankle fracture may also result. It is very difficult to distinguish one from the other without the help of an X-ray. Previously, you can find out if there is a fracture by gently pressing your fingers on the ankle on the right and left. If there is no pain when pressing on the protruding bones of the joint, then this is a sprain.If there is – even a minor – fracture.

Also, the joints of the hands often suffer from sprains, less often the elbow and knee joints are exposed to this injury. Stretching of the shoulder joint occurs with a sharp wave or jerk of the hand.

A sprain of ligaments can be confused not only with a fracture, but also with a crack in the bone, with a rupture of the ligaments. Therefore, if you pulled a leg or arm, you need to put an elastic bandage on the site of the injury and do not disturb the injured limb on this day.However, if the next morning the pain does not subside, and the swelling continues to increase, go to the emergency room.

Golden Rule

When the chest is bruised, many mistakenly bandage the chest with handkerchiefs. Overtightening relieves pain due to decreased inspiratory force. But after two or three days of such “treatment” complications, even pneumonia, may develop. On the contrary, avoid passive mode, do breathing exercises.

In case of sprains, bruises and fractures, do not use warming ointments, which give a burning effect.From them, the swelling increases, and the hematoma (that is, a bruise) can fester.

The golden rule of traumatology: for any injury – bruise, sprain or fracture – the first two days should be exposed to cold to relieve swelling and avoid the development of hematoma. And then – dry heat. If the affected area is not plastered, then apply a hot water bottle with ice or a plastic bottle of cold water to it for the first days. And after two days, wrap it in a blanket and apply a warm heating pad once a day.

Ankle pain – causes, diagnosis and treatment

Pain in the ankle is a nonspecific symptom indicating the pathology of the ankle joint, the epiphyseal ends of the bones forming it, as well as ligaments, tendons and tendon sheaths.The pain syndrome can be based on various reasons – mechanical damage, autoimmune inflammation, malignant neoplasm, degenerative process. The pains can be aching, throbbing, burning, pulling, bursting, etc., sometimes depending on external factors. Diagnostics is carried out using X-ray, CT, MRI, arthroscopy, joint puncture. Until the cause is clarified, rest and the use of pain medications are recommended.

Causes of ankle pain

Injury

Pain syndrome is often triggered by trauma (domestic, sports).Traumatic injury occurs during a fall, twisting of the foot, or a direct impact. At the moment of injury, the pain is acute and strong, subsequently the pain sensations dull. Bruises, abrasions are frequent. Soreness is accompanied by edema. There are the following types of damage:

• Contusion of the ankle joint. The most common ankle injury. It occurs with direct impact – a fall, kick or blunt object. Immediately after the injury, the pain is acute, has a high intensity, then weakens, becomes dull.Pain sensations are localized at the site of the injury. Slight to moderate limitation of movement. A bruise can be complicated by hemorrhage in the joint (hemarthrosis), and the pain becomes bursting.
• Sprains and ruptures of the ligaments. The anterior talofibular ligament is usually injured as a result of abrupt twisting of the foot. Injury often occurs during icy periods. In case of injury, intense sharp pain is felt along the antero-outer surface of the ankle.In the future, the pain sensations decrease somewhat, local edema develops rapidly, the area of ​​damage becomes cyanotic or bluish-purple. Movement is sharply limited, the foot is deflected inward. Walking is possible only with support on the heel.
• Damage to the Achilles tendon. Achilles rupture is a professional injury of gymnasts, ballet dancers, occurs during a jump, when falling from a height. The pain is localized in the back of the ankle slightly above the heel.At the moment of injury, the pain is sharp, very strong. The pain gradually subsides, but persists for a long time. Edema develops rapidly. When a rupture occurs, the patient feels a click or crunch of the breaking fibers. There is a marked decrease in the strength of the gastrocnemius muscle. Plantar flexion is weakened.
• Fractures and dislocation fractures. Ankle fracture is usually isolated, or in combination with foot subluxation due to twisting of the leg.The pain in the ankle area is sharp, excruciating, with any touch or movement it becomes unbearable, it can radiate to the lower leg, only slightly weakening over time. On palpation, there is a crunch, pathological mobility. Frequent bruising extending to the entire foot and ankle. Lean support is impossible. In osteoporosis (in elderly patients, with a number of diseases), the clinical manifestations are smoothed out, resembling a bruise.

Degenerative-dystrophic diseases

Degenerative joint pathologies are caused by impaired metabolic processes and microcirculation, which leads to the gradual destruction of cartilage tissue, subchondral bone areas, surrounding soft tissue structures.Often accompanied by the formation of bone growths (osteophytes). The course is chronic, slowly progressive. The outcome may be disability due to significant deformity of the foot and limitation of movement. There are the following types of degenerative processes:

• Ankle arthrosis. Osteoarthritis is common in older people. In young patients, it can develop against the background of previous joint injuries. At first, there are aching pains along the anterior and lateral surfaces of the joint, appearing in the evening or against a background of prolonged stress, passing after rest.With the progression of the pathology, pain sensations increase, become shooting, occur at night, at the beginning of the movement (“starting pain”). Sometimes a crunch is heard while walking. In the final stage, the formation of persistent deformity of the joint, severe limitation of support and walking is possible.
• Osteochondropathy. The defeat of the scaphoid bone of the foot (Kohler’s disease I) is usually found in boys 3-7 years old, is observed with the formation of foci of aseptic necrosis due to impaired blood circulation in the subchondral areas of the bone.Clinical signs include swelling of the dorsum of the foot, pressing or burning pain in the front of the joint and in the medial part of the foot, aggravated by walking. Lameness is determined with support on the outer edge of the foot.

Inflammatory pathologies

At the heart of inflammatory processes in the ankle joint and its ligamentous apparatus is often aseptic inflammation due to abnormal load on the ankle (obesity, wearing high-heeled shoes, flat feet, professional sports).In other cases, the etiological factor is the penetration of an infectious agent through damaged skin or through the blood. The following inflammatory diseases, accompanied by pain in the ankle, are distinguished:

• Achilles tendonitis. Inflammation of the Achilles tendon is often found in athletics, sometimes due to long-term use of antibiotics from the fluoroquinolone group. At first, the pain in the area of ​​the heel tendon in the back of the ankle is insignificant, has a pulling character, worries only in the first minutes of the load.Subsequently, the intensity of the pain gradually increases, it becomes burning, constant. Even a long rest does not bring relief. There is a slight local swelling and difficulty in movement. Fibrous tissue build-ups around the tendon may form.
• Synovitis. Inflammation of the synovium occurs in many acute and chronic pathologies of the joint. In an acute process, the pain is diffuse, bursting, intense, the joint is significantly increased in volume, and movements are limited.In chronic synovitis, pain is weak, aching, arises gradually, and intensifies as fluid accumulates in the joint. Joint volume depends on the amount of effusion.
• Bursitis. Achilles bursitis and ankle bursitis are formed with increased stress, trauma, rheumatic pathologies. Characterized by growing burning and bursting pain in the posterior and lateral parts of the ankle, progressive edema. Sometimes a soft tumor-like formation is palpated.Movements are usually saved. When infected, the pain intensifies, becomes diffuse. The skin over the bursa turns red, signs of general intoxication join – weakness, fever, chills.
• Viral arthritis. Arthropathies in viral infections (measles, chickenpox, hepatitis B, C) usually appear in the prodromal period, precede other symptoms – skin rash, jaundice, etc. Symmetrically involve the joints of the hands, knees, ankles. Moderate pain, aching, localized on the front surface of the ankle, does not restrict movement.Slight swelling is possible. Arthritis regress on their own without any treatment, do not leave deformities, contractures.
• Tuberculous arthritis. Usually diagnosed in the elderly and children with pulmonary tuberculosis. At first, arthralgias are poorly expressed, do not have a clear localization, bother the patient only with sudden movements and quickly pass. As tuberculosis progresses, pain increases. The joint gradually swells, the skin becomes hot, but does not redden, the movements are limited.In the outcome, deformation and contractures are often observed. Arthritis is accompanied by a general tuberculosis clinic – low-grade fever, weight loss, sweating.
• Gonococcal arthritis. Occurs in 5% of patients with gonorrhea, mainly in young women. Asymmetric lesions of the ankles and knees are characteristic. Typical migrating aching arthralgias, transient swelling due to inflammation of the tendons and bursae. Ankylosis can develop fairly quickly.With massive colonization by gonococci, the pain becomes diffuse, bursting, the skin over the joint turns red. Arthropathy is accompanied by cutaneous pustulosis, fever.
• Brucellosis arthritis. Joint inflammation is the most common manifestation of brucellosis (about 90%). Symmetrical diffuse aching, pulling pain sensations localized in large joints, spine are observed. The course of arthritis is undulating. Due to the defeat of the periarticular tissues (ligaments, tendons), the ankle area swells greatly, movements in the joint are limited.Sometimes ankylosis develops.
• Purulent arthritis. Suppurative inflammation of the ankle is usually the result of an open fracture or osteomyelitis of the distal tibia. Strong, diffuse, pulsating, bursting pains appear. The joint swells, the skin becomes red, becomes hot to the touch. Any movement causes a sharp painful reaction. With the accumulation of a large amount of purulent effusion, the phenomenon of fluctuation is added.Symptoms of general intoxication are expressed – fever, chills, weakness.

Rheumatological diseases

Pain in the ankle often indicates the presence of rheumatological pathology. The pathogenesis of such diseases is due to the formation of autoantibodies that attack the own cells of the macroorganism, including the cells of the synovial membrane. Distinctive features of the diseases of this group are the uncertainty of the etiological factor (the exception is rheumatism), a chronic course with exacerbations and remissions, diffuse pain over the entire surface of the joint, the presence of extra-articular lesions, and a variety of clinical manifestations.Most common rheumatic pathologies:

• Rheumatoid arthritis. More common in young women (30-40 years old). It is characterized by a systematic process with symmetrical involvement of several joints (especially the hands), but it can also debut from the ankle. Arthralgias are prolonged, aching, more intense at rest, passing about an hour after the start of physical activity. Morning stiffness is typical. With the progression of the process, the pain increases, persistent deformity of the joints develops, disabling the patient.
• Ankylosing spondylitis (ankylosing spondylitis). Diagnosed in young men. The spine, sacroiliac joints, large joints, enthesises in the lower extremities are mainly affected. Pain in the ankle is not very pronounced, but it is permanent. The pains are aching, dull, worse in the second half of the night and in the morning. Puffiness and limitation of movement are practically absent. Uveitis is also noted (redness of the eyes, lacrimation, photophobia).
• Psoriatic arthritis. Associated with severe skin disease – psoriasis. Typically, the development of progressive asymmetric oligoarthritis, leading to disability. In the ankle, there are constant aching pains of moderate intensity, slight swelling. The color of the skin is burgundy-bluish. Specific signs are arthritis of the distal interphalangeal joints, nail damage (punctate depressions, dystrophy of the nail plates, onycholysis). Localization of psoriatic plaques – scalp, elbows, knees, intergluteal folds.
• Rheumatic fever. Arthritis is considered the main symptom of rheumatism. Characterized by short-term arthralgias that occur about a week after suffering an acute streptococcal infection of the upper respiratory tract. The joints become enlarged due to edema, and movement is limited. Painful aching, pulling, moderate activity, migrating (moving from one joint to another). The inflammation is benign, quickly passes without any residual effects. Almost always accompanies rheumatic carditis.
• Reactive arthritis (Reiter’s syndrome). The main reason is recently transferred urogenital (chlamydia, mycoplasmosis) or intestinal infections (shigellosis, dysentery). Often seen in young people. There is an asymmetric lesion of the lower extremities (joints, tendons, enthesises). The severity of arthritis has a wide range – from minor undulating to constant unbearable pain sensations with sharp swelling. The process is prone to chronicity with an unfavorable outcome.Sacroiliitis is typical. Arthritis is accompanied by urethritis, conjunctivitis.
• Collagenoses. The group of diffuse connective tissue diseases includes systemic lupus erythematosus, systemic scleroderma, dermatomyositis. They are united by a variety of clinical picture, involvement of the skin, internal organs, joints (including ankle). Arthritis often comes to the fore and is the initial sign of the disease. Arthralgias are usually symmetrical, with moderate aching pains, pass quickly, do not restrict movement, are not accompanied by edema, and do not lead to deformities.
• Inflammatory bowel disease. Sometimes ankle soreness indicates inflammatory bowel disease (Crohn’s disease, ulcerative colitis, Whipple’s disease). Typical spondyloarthritis, asymmetric arthritis of the knees and ankles with minor aching migrating pain. There is no restriction of movement. The degree of arthralgia correlates with the activity of intestinal inflammation. The deformation does not develop. Along with arthropathies, the clinical picture includes enteritis, iridocyclitis, erythema nodosum.

Systemic metabolic disorders

In some diseases, increased production or decreased utilization of certain substances leads to the accumulation of various proteins or metal ions in internal organs and joints. This group of pathologies is distinguished by a hereditary nature or the presence of a predisposition, a wide range of clinical signs, a progressive course, and resistance to therapy (with the exception of gout). Ankle pain can be associated with the following metabolic diseases:

• Gout. Caused by increased production and decreased excretion of uric acid, which leads to its accumulation in the tissues of the joints. It proceeds in a paroxysmal manner. A gouty attack is provoked by the intake of fatty foods, alcohol. The painful sensations are acute, burning, bursting, sometimes unbearable. The joint is swollen, the skin over it is hot. Possible tophuses on the skin. The attack is accompanied by fever, chills. In the interictal period, there are no symptoms.
• Amyloidosis. Characterized by the deposition of a specific fibrillar protein, amyloid.Joint inflammation is usually destructive, proceeding similarly to rheumatoid arthritis – with morning stiffness, arthralgia of several joints, aggravated at rest and decreasing with movement. A distinctive feature of pain in amyloidosis is its higher intensity at night. The end result is almost always deformity. Also neuropathies, renal, heart failure occur.
• Hemochromatosis (bronze diabetes). Chondrocalcinosis develops in hemochromatosis due to the deposition of calcium pyrophosphate.Arthropathy can progress gradually with “mechanical” arthralgias, as in osteoarthritis, or in the form of acute arthritis, resembling gout. The skin becomes dark brown or bronze in color. Due to hormonal disorders, baldness, diabetes mellitus, hypogonadism join. Liver cancer is found in 30% of patients.

Tumors and tumor-like diseases

Tumors or tumor-like formations are quite rare causes of ankle pain.The pains are usually diffuse, have no connection with physical activity. Pain syndrome can be caused by benign hyperplasia of the villi of the synovial membrane, cartilaginous metaplasia, aggressive tumor growth, less often – metastatic damage to the joint tissue. The following pathologies are distinguished, accompanied by pain in the ankle area:

• Benign neoplasias. Synovial chondromatosis, pigmented villonodular synovitis. Typically, one joint is involved.Development is gradual. Painful sensations are dull, not intense, slowly progressing. Sometimes a hard formation is felt in the joint area. Younger men are more likely to suffer.
• Malignant neoplasms. This group includes synovial sarcoma, chondrosarcoma, metastases from other organs. The pain is growing, diffuse, strong, exhausting, can spread to the lower leg, is accompanied by severe restrictions on movement, correlates with tumor growth.Arthralgias can also occur as a manifestation of the paraneoplastic syndrome, in which the body responds to the growth of a malignant tumor by producing antibodies that attack the tissues of the joint. In such cases, one or more joints may be affected by the type of reactive or rheumatoid arthritis.

Survey

In case of pain in the ankle, you should consult an orthopedic traumatologist, rheumatologist. When making a diagnosis, the specialist takes into account the nature of the pain, their duration, evaluates the configuration of the joint, the range of motion, the color of the skin, the presence and nature of edema.To find out the cause and assess the severity of the process, an additional examination is assigned, including:

• Blood tests. In a general blood test, markers of inflammation can be determined – leukocytosis, a shift in the leukocyte formula to the left, an acceleration of the erythrocyte sedimentation rate. In autoimmune pathologies, acute phase proteins (C-reactive protein), various antibodies (rheumatoid factor, antinuclear, anticentromeric antibodies) are found in the blood. In infectious arthropathies, specific immunoglobulins to the antigens of bacteria and viruses are detected.
• Arthrocentesis. In case of suspicion of microcrystalline and infectious arthritis, arthropathy in malignant neoplasms, a study of synovial fluid obtained during a joint puncture is indicated. In order to detect crystals of uric acid salts, bacteria, atypical cells, polarization microscopy, bacterial inoculation, cytological analysis of punctate are carried out.
• Imaging studies. Imaging methods are very informative for assessing the structure of the joint and surrounding tissues: X-ray of the joint, computed and magnetic resonance imaging.In some cases, ultrasound of the joint is prescribed. The presence of pathology is evidenced by a narrowing of the joint space, subchondral osteoporosis, destruction of cartilage, effusion in the joint cavity.
• Arthroscopy. An endoscopic examination is indicated for a detailed study of the articular structures. The technique makes it possible to visually assess the condition of the articular ends of the bones and the joint capsule, to take a biopsy sample for histological examination.

Fixing bandage for ankle

Symptomatic treatment

Treatment of ankle pain should be based on the underlying cause.Symptomatic therapy allows you to alleviate the patient’s condition, but is only a temporary measure. For the purpose of pain relief and to reduce inflammation, you can use non-steroidal anti-inflammatory drugs in the form of tablets, injections, ointments. After an ankle injury, it is recommended to apply cold (hot water bottle, ice pack) to reduce swelling and pain.

If possible, it is worth limiting movement in the ankle; a fixation bandage should be applied while walking.At rest, you should give the leg an elevated position. Do not overload the joint (running, jumping, brisk walking), use warming compresses. Some conditions (trauma, synovitis) require urgent medical intervention, therefore, in case of deformity, pathological mobility (“laxity”), severe pain and swelling of the ankle, an intense feeling of fullness, you need to call an ambulance.

90,000 Tendonitis. Tenosynovitis. Ankle sprain.Splitting of the tibia. Ankle swelling.

Ankle sprain. Splitting of the tibia. Ankle swelling.

Tendovaginitis – inflammation of the tendon sheaths. Distinguish between infectious tenosynovitis, crepitus and stenosing.

INFECTIOUS tenosynovitis can be acute or chronic, serous or purulent. An example of an infectious tendovaginitis is a tendon panaritium.With it, the sore finger is evenly enlarged, slightly bent and painful. Pressure over the tendon sheath and an attempt to induce passive movements are accompanied by sharp pain. The vagina becomes infected all over within a few hours. The general condition of the patient is severe due to intoxication.

Treatment of infectious tendovaginitis is mainly surgical.

CREATIVE TENDOVAGINITIS – aseptic inflammation of the tendon sheath or (which is more common) of the tissue surrounding the tendon.Crepitating tendovaginitis develops on the extremities (more often the upper ones) mainly in connection with physical work, as an occupational disease (milkmaids, laundresses, volleyball players, etc.) or, conversely, when performing prolonged unusual physical work. TREATMENT crepitant tendovaginitis outpatient. A plaster splint is applied to the affected limb, therapeutic baths and therapeutic exercises are performed. Treatment with Rosenthal paste is effective (iodine – 0.3 g, wine alcohol – 10 g, paraffin – 15 g, chloroform – 80 g).The affected area is smeared with a heated paste, after it hardens, a cotton bandage is applied.

STENOSING TENDOVAGINITIS – aseptic inflammation of the annular ligament of the finger (“springy finger”, “snapping finger”) or the dorsal ligament of the wrist. In the etiology of this type of tendovaginitis, acute or chronic trauma, carrying weights, is of great importance. Most often, the disease develops in women 30-50 years old.

TREATMENT . At the beginning of the disease – immobilization of the finger in a physiological position with a removable plaster splint, warm baths, paraffin therapy.If the therapeutic treatment is ineffective, it is necessary to consult a surgeon.

Tendinitis. painful changes. Like Achilles tendonitis, ankle sprains and splitting of the tibia are injuries that occur as a result of sports activities. Sometimes (if you are especially unlucky) all three injuries occur together. The swollen ankle that often accompanies Achilles tendonitis is actually a non-medical definition for mild sprains.

TENSION OF THE ANKLE JOINT – vary in severity. More often than others, this injury is suffered by athletes or women who, while walking in high heels, stumble on a curbstone and twist their leg, shifting the ankle inward. This movement, which accounts for nine out of ten sprains, can lead to partial tears of the ligaments on the outside of the ankle. If the ankle is rotated outward, the ligaments on the inside of the ankle may suffer.This type of sprain is less common and requires longer treatment than a sprain that damages the ligaments on the outside. Even less common are ligament injuries on both sides of the ankle.

The latter type of sprain is very severe and is usually the result of a fall. This most often happens to people who have already sprained their ligaments. For this reason, pregnant women whose ligaments are weakened as a result of hormonal changes should pay particular attention to shoes that help stabilize the ankles.

The main symptoms of a sprained ankle are swelling and pain. When the ankle is tucked, pain is felt first, followed by swelling. But not every stretch is immediately apparent. Sometimes, with an increase in physical activity, swelling appears, and the ankle will begin to hurt only after a few days or weeks. This type of sprain creeps up unnoticed. You can ignore what is happening for a long time, and the swelling gradually becomes strong enough, and the ligaments are torn so much that they make you moan in pain.These “progressive ” sprains can be avoided by applying ice and resting the legs at the slightest sign of overload.

If swelling and pain in the ankle develops, seek medical advice immediately. An x-ray must be taken in order to exclude a fracture or displacement of the joint; in addition, the specialist may order an MRI to determine the extent of the damage to the tendon. It is important to assess the severity of the sprain as early as possible, because the extent of the injury determines how long it is necessary to stop activities that increase the load on the foot.Even after the lightest stretching, you can resume exercises with an increased load on the legs no earlier than six weeks later. Too short a rehabilitation period can lead to a repeated cycle of recurrent sprains and the development of degenerative arthritis of the ankle joint.

TIBLE SPLITTING is really painful. It hurts so much that when intense pain strikes the lower leg for the first time, it feels like a lead pipe has been hit on the leg.And here’s why: in the lower leg, two important muscles attach to the tibia, and they literally break away from the bone when a thin plate rises from it during splitting. The larger the gap, the stronger the pain. The tissue around the bone becomes inflamed and swollen.

My tibia has split, as it happens in many people, when I decided overnight from a sedentary, complete doctor and mother of the family to turn into a runner with excellent athletic shape. My Achilles tendons were too stiff for such an ambitious training program; the feet were unaccustomed to the loads I put on them, they were severely twisted inward, and they directed the weight of the body forward, and the muscles around the tibia were terribly overextended.As a result, two weeks later my legs were swollen and I could not walk without pain even from my apartment to work. This was the end of my “career as a runner”. Eventually, I had to replace running with a powerful walking program (after the fracture had passed) that better suited my wellness goals and my body condition.

Most of my patients get a split tibia in exactly the same way as I do, starting an over-exertion training program without a sufficient level of training.However, even those who have been exercising for a long time may face a split tibia. When this happens, you need to reevaluate your daily workload. There is another danger (even if the body is in top shape): splitting of the tibia can occur when no allowance is made for age. A set of exercises that are perfect for thirty-year-olds may be overkill for a person at forty-five.

PREVENTION AND SELF CARE. With an ankle sprain (after X-ray and exclusion of a fracture), the result of treatment depends: on our patience and following all the prescriptions received from the physiotherapist.

To begin with, you need to remember: ankle sprains are treated with cold, not heat. For the first twelve hours after injury (there is no need to postpone a visit to the doctor), lift your leg and apply a container of ice to it in the stretch area for fifteen minutes every hour. It is very important to apply ice every hour for the first day. Many are aware of the need for cooling when stretching, but they do not have the patience to heal on their own. Ice controls the swelling by reducing blood flow to the damaged area (Heat increases blood flow, which should be avoided immediately after stretching).However, it is important to keep the ice on for no more than twenty minutes in a row, as the blood vessels then begin to dilate in an attempt to increase the blood supply. Over-the-counter cooling compresses keep cold but do not set and are easy to shape. They can be stored in the freezer and reused.

While cooling your leg, lift it up. Since the foot and lower leg are far from the heart, blood collects in the damaged area. If possible (for most this is a difficult task), after injury, try to keep your leg elevated for twenty-four to forty-eight hours, or as much as you can.

Crutches or a light, breathable cast provide rest for the leg, but in both cases in combination with a pressure bandage (sometimes for weeks). Compression stabilizes the ankle, allowing you to move with less pain.

Once the severe swelling has been relieved, a physical therapy program will begin, which can include anything from exercises that stretch the heel tendon to electrogalvanic stimulation designed to relieve residual swelling.Depending on the severity of the stretch, the swelling and pain can last from two weeks to three months. If your daily routine includes a set of exercises that increase the load on the foot, talk to your physiotherapist about how soon and to what extent you can resume the previous load.

Ice and rest are also required for self-treatment of tibial splitting. Exercises that stretch the Achilles tendons and calf muscles are beneficial for both splits (prevention and maintenance) and ankle sprains.Using an elastic band around your shin will help relieve shock if you twist too much inward. When I started using the orthopedic inlays in my walking shoes, my tibia splitting stopped. But the splitting does not completely go away from applying ice and stretching. To make sure that there is no crack in the shin, you should definitely see a doctor. SPECIAL ADVICE FOR WOMEN. If you suddenly develop a split tibia after age forty-five, an x-ray and a bone density test should be done.Like impact cracks in the calcaneus, this can be a warning of bone collapse, which will eventually develop into osteoporosis.

TENDINITIS – INFLAMMATION OF THE ACHILLES ‘HEEL

PAINFUL CHANGES. The Achilles tendon is one of the most important in our body and the most vulnerable to damage. This tendon, also called the calcaneus, is an extension of two muscles: the gastrocnemius and soleus. It connects the calcaneus to the muscles that give it mobility and allows us to move our toes.When the heel tendon is too tight, tension is felt throughout the foot, especially in the plantar aponeurosis ligament, which contracts and stretches with every step.

Think of the ropes used to raise and lower the blinds. If the ropes are unraveled and of equal length, the blinds rise and fall easily, but if one of the ropes is tangled in a knot, it is difficult to get the blinds to move. Although the calcaneus tendon and the plantar aponeurosis ligament are not equal in length, they can interact like the blocks and ropes of a blind, producing a smooth movement.

If the tendon is too tight, the plantar aponeurosis ligament and other soft tissues of the foot have to stretch harder to allow the legs to move one after the other. The foot rolls too far inward, creating excessive pronation to compensate. After a while, pain occurs in the sole, tendon and heel. Achilles tendonitis is an inflammation that develops suddenly or, if the tendon is not elastic enough to accommodate the pressure exerted by the lower leg, ankle and foot.Nature has endowed us with some freedom in contraction and excessive tension of all tendons and joints: the crunch of the joints of the fingers does not cause pain, but it shows that this part of the body is overstrained, which means it is capable of excessive stretching.

Unfortunately, the ability to stretch decreases with age. When a tendon is overstretched at forty, it does not immediately return to its original position, as it did at twenty. Therefore, after forty, starting to engage in fitness, you need to gradually specifically stretch the Achilles tendons.Overexertion is not the only culprit for tendonitis: many women experience tendon pain when they suddenly switch to flat-soled shoes if they have always worn high heels before. The tendon has never been stretched to the ground and it “protests”. For the foot, an unusual stretch can be equivalent to running ten kilometers.

SYMPTOMS . There are three main degrees of damage to the Achilles tendon.

• A first-degree sprain, which is the mildest, feels sore in the back (and often on either side) of the ankle.Sometimes there is sharp pain in the calf and difficulty in lifting toes or transferring weight to the heel. A clicking sound is heard when the ankle moves, as the soft tissue sheath may be damaged, allowing the tendon to slide easily over the bone. If you have these symptoms, immediately rest your leg, lift it up, and apply ice to the affected area. The most common and common mistake is going about your daily activities, hoping that the pain will go away if you don’t notice it. If you continue like this, the sprained ligament can break.

• In a second-degree injury, the ligament is partially detached from the bone. The sensations are the same as with damage of the first degree, only stronger. If the pain lasts more than two days, see your doctor for a diagnosis. (An experienced orthopedic surgeon or trauma surgeon can often tell if there is a partial tendon tear from the tenderness of the ankle, but a regular doctor will likely refer you for an MRI.) The second degree of injury is both more serious and requires a much longer period of immobility.With a first-degree injury, you can walk if you bandage your ankle tightly after forty-eight hours. With a second-degree injury, recovery can take up to eight weeks, and a flexible cast will need to be worn for several weeks.

• In a third-degree injury, the tendon is completely torn from the bone and some adjacent muscles may be torn. Full separation will be corrected only by the operation. If your Achilles tendon is torn, you will need the help of an experienced trauma and orthopedic surgeon .Most Achilles tendon injuries are not in the third category, but in the first two, and a good podiatrist will usually use non-invasive medical treatment before recommending surgery.

Note: Ankle sprains can accompany all types of damage to the Achilles tendon.

FROM MY CARD ROOM . David, who first became a father at fifty, was running after a ball thrown by his three-year-old son when he suddenly felt a sharp pain in the back of his ankle.By the end of the day, the ankle was swollen and David could not lean on it. On Monday morning, he found himself in my waiting room, loudly wondering how this could happen if he was not running fast and not far away.

This was (fortunately) a typical case of grade 1 tendinitis. David had been putting ice on his ankle all Sunday, and by the time I examined him, the swelling had already begun to subside. But David was very upset when he heard that if he wants to fully recover and avoid re-injury to the tendon, he should not run for 6 to 8 weeks and carry his thirteen kilogram ammonia son on his shoulders.It is unpleasant for people of any age to hear that they can harm themselves, because they are not in good enough shape. In my experience, men find it more difficult to come to terms with physical limitations than women. In addition, David’s desire to mess with his little son, like young fathers, was completely understandable.

I explained to David that after his ankle was restored, he would play with his son for many years to come. After applying a tight bandage, I recommended that he continue to apply ice several times a day and spend as little time as possible on his feet for at least a week.In addition, I placed a heel-lift in his boots to allow the Achilles tendon to rest from the usual pull.

When a woman who prefers flat shoes comes to me with a similar injury, I advise her to switch to heels up to three centimeters high. But women who tend to wear high heels are most difficult to treat: although they need low heels to provide stability during the convalescence period, their tendons cannot adapt to excessive tension.Choosing the right footwear for these patients is always a compromise.

It is important for the patient to begin physiotherapy as early as possible. It can include electrical stimulation, ultrasound, and stretching exercises under the supervision of a specialist. If the Achilles tendon is damaged, it is imperative to carry out rehabilitation under the supervision of a professional in order not to harm yourself. A physical therapist will recommend home exercises to straighten and stretch the hamstrings, lower calf muscles, and heel tendon.

Even with the first degree of damage, it will be possible to start active exercises in four to six weeks. With grade II damage, the tendon does not heal in six or eight weeks, and it will take an additional month of stretching exercises before returning to previous levels of exercise.

In general, care must be taken when returning to the previous mode even after the damage has healed. For example, if a person is injured running fifteen kilometers a day, they will have to wait more than three months before one can hope to run that distance without hurting themselves again.And any physiotherapist will say that it is more prudent to limit yourself to running for seven kilometers, regardless of the period that has passed since the moment of injury, and your well-being.

It is often very difficult to convince people who are passionate about gymnastics to reduce the load.

Most of the first and second degree injuries respond to conservative treatment. However, it happens that pain continues to bother the patient (especially with a second degree of injury) for weeks, and pain relief is the most controversial thing in pediatric and orthopedic practice.

Occasionally, especially if there is unusual swelling around the Achilles tendon sheath, your doctor may recommend a topical anti-inflammatory injection of corticosteroid . This often relieves swelling and causes immediate pain relief. But there is a danger in this: the anesthetic injection creates the mistaken impression that the tendon is healed, and provokes a relapse, masking the most important warning signal – pain.

The widespread practice of treating sports injuries with steroids so that the athlete can keep playing often leads to severe injuries.If the Achilles tendon (or any other) hurts so much that it cannot bear the weight of the body without repeated injections, then it is not necessary to transfer this weight to it at all. Many patients with painful Achilles tendon injuries ask for injections because they want to get back on their feet for an important event. Sure, corticosteroid will allow you to dance at a wedding or play ball during a friendly picnic, but at what cost? A dance with a damaged tendon can result in three additional months of treatment.If your doctor refuses to give you an injection, do not try to find another willing to accept. Listen to the doctor’s words about the dangers of hidden pain.

Often, when pain returns during the recovery period, over-the-counter anti-inflammatories containing aspirin or ibuprofen are sufficient. For patients who are recovering normally but have low pain tolerance, I prescribe the stronger non-steroidal anti-inflammatory drugs .During the rehabilitation period, a relapse can be expected (especially if the tendon is partially ruptured), therefore I recommend the patient to be monitored by a professional physiotherapist for several weeks. The doctor will find out if the pain is due to a new injury or if it is just part of the normal healing process.

PREVENTION AND SELF CARE. Almost all damage to the Achilles tendon can be prevented with stretching exercises. The exercises I have recommended for plantar fasciitis may help in part.If you only have time for one set of warm-up exercises, then choose it. Straightening and stretching exercises for the hamstrings and calf muscles are also important. Your ability to do these exercises is highly dependent on your physical condition and you should seek the advice of your physical therapist before starting them. Even if you have exercised repeatedly, it is advisable to get advice from a professional physiotherapist during your rehabilitation period.

For mild plantar fasciitis and Achilles tendonitis, custom-made shoe inserts that support the arch of the foot during exercise can help prevent further development of these conditions.Attention: you need to start using the tabs not immediately after damage, but already in the process of recovery. The doctor should explain to you how to “wear out” the new tabs.

If you suspect damage to the Achilles tendon, if you can not immediately see a doctor, you should keep your foot and ankle at rest, keep them in an elevated position and cool with ice.

If the damage to the Achilles tendon occurs during daily activities, such as walking off a curbstone, then improperly fitted shoes may be to blame.Household injuries of this kind are rare in men, but women often twist their ankles, moving in high, thin heels that disturb the balance.

But most often in both women and men, damage to the Achilles tendon occurs during heavy exercise. It is important to correctly assess the capabilities of each individual person and to distinguish overstrain from light sprains or from serious injury. Was this due to the fact that you recently increased the load in your daily exercise? The answer is not always obvious, because many people increase the intensity of the exercise without noticing it.

Maybe you added new moves that you didn’t do before the damage? One of my patients who has attended tap dance for many years developed tendonitis when she switched to modern dance. What is the reason? Tap dance shoes have low and thick heels, and modern dancers wear soft, flat-soled shoes when dancing. Her Achilles tendon was too stiff to accommodate the resulting excessive tension.

Are sports shoes suitable?

Don’t delay seeking medical attention in the hope that the pain will go away on its own.It is especially important to establish the exact extent of soft tissue damage, because when walking, a small tear can turn into a large tear.

The severity of the pain does not always correspond to the severity of the injury. If the surrounding muscles are strong and the person is in good physical shape, the pain may be mild. However, a dismissive attitude to trauma can lead to an emergency. In contrast, acute pain does not necessarily mean that the injury is extremely serious: the injury may be close to the nerve, or you have poor pain tolerance.Sometimes Achilles tendonitis and ankle pain are accompanied by a fracture of the heel bone. In this case, the doctor will recommend a soft plaster shoe until the fracture heals.

SPECIAL ADVICE FOR WOMEN. Don’t wear slides or flip flops for long walks, even if they’re comfortable on your feet. They destabilize the ankle and this can lead to stretching and inflammation of the Achilles tendon. Whether we think about it or not, a regular walk is a load, and the heel needs support.In addition, mules cause undue stress on the forefoot because the muscles of the toes are used, knowingly or unknowingly, to keep the shoes from falling off.

Treatment of tendinosis, bursitis, heel spur, polymyalgia.

What do a heel spur, epicondyllitis, back pain, knee pain, hip or shoulder pain have in common? All these pathologies are effectively treated with bee venom.

Pain syndrome very often occurs at the end points of the muscles and in the places of attachment to the bones, where an area with reduced blood flow is created.

In patients who suffered from extremely severe pain syndrome associated with tendinosis and could not sleep at night, injecting children’s doses of bee venom restored blood circulation and anesthetized due to the adolapine contained in bee venom, while anti-inflammation flax therapy with other components of bee venom was administered.

As concomitant orthopedic diseases, arthrosis and degenerative diseases of the intervertebral discs are usually noted, which responded to the treatment with the restoration of functions, even if BAP were not used for their treatment.

In acute pathology, treatment was carried out daily with the use of bee products: honey – at least 1 tablespoon per day, preferably before bedtime, apilak in the morning – 1-2 tablets, bee pollen – 1 teaspoon. In addition, daily lubricate with 15-20% propolis in oil 3-4 times a day joints, back 1 time a day, places with a pronounced pain effect 3-4 times a day. Alcohol-containing substances that destroy bee venom were completely excluded.

Sometimes the patients regained sleep immediately after the first session, in other cases it took two or three days, when the pain syndrome was completely stopped and the condition improved.No side effects were observed.

My experience has shown that treatment with bee venom prevents chronic pain syndrome and creates an optimization for subsequent courses of therapeutic exercises.

After 5-7 sessions, you can switch to bee venom treatment every other day by connecting clay therapy: first, once a week, a bath with blue clay (200 grams of clay dissolved in water at a temperature of 36-37 °), duration of admission 20 minutes for 2- 3 weeks; then 2 baths a week, duration of admission 20-30 minutes, in total not less than 10 baths.I draw your attention once again, baths must be alternated with apitherapy sessions. The proposed technique allows to relieve pain syndrome much faster, providing high treatment efficiency. In the future, using clay therapy, you can maintain remission for up to 5-6 years. Thus, the self-regulating properties of the body are activated, the defenses are mobilized, the effects achieved are stable in the absence of side effects.

For treatment order : 1. Shilajit – 3 pack Mumiyo from Kazakhstan, the best in the world – used for ointment with honey and ingestion. Possesses anti-inflammation and adaptogenic properties. Removes the inflammatory component of the disease. Enhances the positive effect of other drugs. The daily minimum dose is 0.2 g, but more often is needed. Drink, diluted with warm water, in the morning on an empty stomach. After a ten-day intake, take a break for five days.Then carry out the second course of treatment. For fractures of large bones, three courses are recommended.

Treatment example : Open leg fracture. The result is osteomyelitis. How much torment he took! They cleaned his bone and stabbed him with injections – all to no avail. The process of decay was faster than healing . This is how the pictures were shown. The temperature was kept for 2 months at 37.2-37.7 °. Suggested recipe : For a glass of boiled water at room temperature, 2 g of mumiyo.Mumiyo should be pure. Dilute until completely dissolved. It turns out a cloudy brown liquid. Drink 1 tbsp on an empty stomach. spoon a day. 1 glass of diluted mumiyo was enough for us. After 2 days, his temperature began to drop. The healing process went fast. With osteomyelitis of the hip bone, 7 g is needed, also in a glass of water. Taste, as my husband used to say, of rotten pear.

Treatment example : An 82-year-old woman broke her leg. After a month and a half, she was already doing without crutches.Fantastic? No. Simply, the healing property of mummy makes the old body young by enhancing tissue regeneration. It is believed that in the mummy itself there is a building material for the restoration of bones.

2. CHORD  light – 330 ml . – rheumatoid arthritis, arthritis, osteochondrosis, arthrosis, gout, sprains, tendons, tendonitis, tendovaginitis, cracks, fractures, preservation of youth and joint mobility in old age.

EFFECTS ON THE INFLAMMATORY COMPONENT OF THE DISEASE :

1. CHORD ‘LIGHT – 100 ml ., 330 ml .

– IT HELPS YOUR JOINTS HEALTHY YOUR JOINTS. The best drug from the company VITAUKT

LIFE IN MOTION. MOVEMENT WITHOUT PAIN!

JOINT PAIN? BACKACHE? DOES EVERY STEP CAUSE SUFFERING? SUSPENSION AND RESTRICTIONS OF MOVEMENT?

BE IN RHYTHM WITH LIFE TRAFFIC CONTROL AND EVEN MORE

WHEN PAIN GOES OUT, FREEDOM COMES!

Natural remedies are very effective for arthritis and arthrosis.You just need to know which …

The joints are constantly under heavy stress. At the same time, nature did not really care about their nutrition. Cartilage does not have its own vessels. In case of malnutrition of the cartilage with age or under the influence of trauma, infections, it gradually atrophies. And he can no longer recover without outside help. With thinning of the cartilage in the joints of the arms or legs, with each movement there is an increase in pressure on the periosteum, where the nerve endings are located.Hence the pain in the joints. In response to pain, edema develops, and the range of motion is limited. The inflammation becomes chronic.

Despite the large differences in the cause of the occurrence (previous infection, autoimmune conflict, disorders of uric acid metabolism, etc.), joint diseases are based on common development mechanisms. The main pathogenetic mechanism in this case is inflammation, which results in damage to the tissues of the joints, the release of exudate (inflammatory fluid) and replacement of damaged tissues with a scar.The alternation of these processes or their simultaneous course forms the clinical picture of the disease (symptoms): joint diseases are characterized by pain, redness, swelling, fever in the affected area, as well as dysfunction of the corresponding joint.

Phytocomplex “ HORDA ‘LIGHT ” has a pronounced anti-inflammatory effect , helps to reduce inflammation and relieve pain in joints.Unfortunately, it is impossible to completely cure arthrosis. But you can slow down or stop the course of the disease. First of all, relieve or at least reduce pain, inhibit inflammation and thus improve the quality of life. It is also necessary to prevent complications and exacerbation of the disease. “ CHORDA ‘LIGHT ” is combined with other physician-prescribed treatments and physiotherapy . When combined with non-steroidal anti-inflammatory drugs, drugs (NSAIDs) enhances the therapeutic effect, which can significantly reduce the dose of NSAIDs taken. Unlike NSAIDs, it has an anti-inflammatory and analgesic effect, without damaging the mucous membrane of the stomach and intestines.

PROPERTIES OF THE COMPONENTS

• Have a pronounced anti-inflammatory effect in patients with rheumatoid arthritis

• Helps relieve pain, muscle tension and joint swelling

• Contribute to a decrease in the daily dose of non-steroidal anti-inflammatory drugs and hormones 90 431 (in some cases, their complete cancellation is possible)

• Contribute to the improvement of the functional state of the musculoskeletal system of the th system, reduce the risk of development and progression of osteoarthritis

• Promote the improvement of cartilage metabolism, followed by a slowdown in its destruction

RECOMMENDATIONS FOR APPLICATION

• Complex treatment of inflammatory diseases of the musculoskeletal system (arthritis)

• Degenerative diseases of the musculoskeletal system of the th apparatus (osteochondrosis, arthrosis)

• Degenerative changes in the cartilage tissue of the joint due to systemic diseases, metabolic disorders (rheumatoid arthritis, gout)

• Prophylaxis for all elderly people who already have age-related changes in the osteoarticular o and musculoskeletal apparatus, as well as athletes experiencing strong physical exertion

• Increased physical activity on the joints (athletes, fitness, shaping)

• Recovery period after injuries of the musculoskeletal system of the leg apparatus (sprain of ligaments, tendons, cracks and fractures)

MOVEMENT IS FREEDOM!

Marsh cinquefoil has antipyretic, analgesic, anti-inflammatory and antirheumatoid effects, exhibits antibacterial activity .

Elm-leaved meadowsweet (meadowsweet). The action of meadowsweet is aimed precisely at improving the periarticular capillaries and restoring the normal nutrition of the articular cartilage. Due to the high content of salicylates in meadowsweet, inflammation and joint pain in arthritis and rheumatism quickly disappear.

White willow is a natural analogue of synthetic anti-inflammatory drugs , which are still the main treatment for osteoarthritis ”.The substances contained in the willow bark extract have antipyretic, anti-inflammatory and analgesic effects. Salicin, which is the main component of willow bark, does not have such an ulcerogenic effect on the digestive tract as synthetic salicylates (acetylsalicylic acid ), only the tannin components of the drug can cause irritation. Studies have shown that salicin metabolizes mainly to form the same end products as acetylsalicylic acid .Unlike acetylsalicylic acid , salicin in willow bark is initially in the form of a mixture of inactive glycosides – a natural drug mixture. In the intestine, salicin is broken down into saligenin and D-glucose and absorbed as saligenin. Saligenin (salicylic alcohol) is oxidized in the blood and liver to form therapeutically active salicylic acid. The therapeutic effect of salicin is complemented by other components of the willow bark extract: flavonoids (kaempferol, luteolin, quercetin), tannins, which determine the main anti-inflammatory and analgesic effect of the extract.As a result of treatment, the severity of inflammation and pain decreases, and mobility in the joints increases. The increased excretion of uric acid, which occurs under the action of salicylic acid glycosides isolated from willow bark, determines their effect on gout

Aspen ordinary – “vegetable aspirin”. Indeed, aspirin, in other words, acetylsalicylic acid I, the very first remedy invented for the treatment of joint diseases, was originally obtained from the bark of willow, whose Latin name is salix.Hence, acetylsalicylic acid . Aspen preparations have anti-inflammation , analgesic, astringent and diuretic properties. For a long time in Russia, aspen decoctions and infusions have been used as a diaphoretic and antirheumatic agent. Aspen preparations have the ability to remove excess uric acid from the body.

Dandelion medicinal helps to improve the metabolism of cartilage with a subsequent slowdown in its destruction. Dandelion root extract contains a monoterpene glycoside – taraxacin.Taraxacin in the human body has two main points of application – the effect on the qualitative composition of the synovial (intra-articular ) fluid as a medium for feeding the articular cartilage and the stimulation of the production of factors for the regeneration of cartilage tissue by the liver cells. Preparations from dried dandelion roots are used to enhance the excretion of harmful substances from the body with sweat and urine, as an anti-sclerotic remedy for gout and rheumatism. Therefore, taraxacin protects and restores the articular surfaces due to the action of taraxacin on two mechanisms of natural exchange of cartilage tissue through the intra-articular fluid and through the blood.As a result, the cartilage tissue is cleansed and regains the ability to heal itself yu.

Horse chestnut exhibits decongestant, analgesic properties. Escin is a mixture of horse chestnut triterpene saponins. It reduces increased permeability, fragility and inflammation of the vascular wall, has antiinflammatory activity . It was found that escin exhibits an analgesic, anti-edema effect.

3. Silymin – in capsules – contains a water-soluble, easily digestible form of silicon, a stimulator of osteosynthesis and a regulator of calcium biobalance. Energy factor of DNA, RNA and protein biosynthesis. Bioelectric impulse catalyst. The main element of bioenergy.