How Long Should A Sprained Ankle Hurt
Ankles are among the most commonly injured joints in sports. The American College of Rheumatology estimates that about 1 million adults had an injury-related visit for their ankle last year, making it the fourth leading cause of visits to rheumatologists. Ankle sprain is also the most common type of injury seen by orthopedic surgeons.
The ankle joint connects your lower leg (fibula) to your foot (tibia). It consists of two bones and three ligaments. The bottom bone is called talus; its top end fits into a depression on the inside edge of the big toe. Talar cartilage covers this area. Ligamentous tissue surrounding the joint attaches from the outside of the tibia to the outer part of the fibula. Here again, there is a small piece of cartilage between these ligaments and the tibia. This covers the joint capsule and helps keep all the moving parts together.
Sprain injuries occur when one or more ligaments around the ankle become stretched beyond their capacity to hold up the joint. If the ligaments tear, they may partially reattach themselves as scar tissue within a few days. But if the ligaments do not fully heal back, further damage to the ankle could result. To prevent this, doctors usually recommend physical therapy to strengthen the muscles around the ankle during healing time.
A sprained ankle heals fairly quickly. Most people recover well in just two weeks. Less than 10 percent of people develop chronic ankle instability (a permanent problem), which often requires surgery. Fortunately, many people experience little long term disability after an acute sprain. Usually, within a week or so, you’ll be able to move around normally again. When you’re ready to get out of bed, place your hand firmly under your thigh, rather than behind your calf. Do not put weight on your ankle until it feels strong enough to support your full bodyweight.
During the first couple of weeks, use ice packs wrapped in a towel to reduce swelling. Afterward, try elevating your ankle above heart level whenever possible. Elevation prevents fluid accumulation around the joint. Don’t wear tight shoes or socks, especially those made of synthetic materials such as neoprene. Loose fitting pants will allow air circulation while keeping your feet warm. Use crutches or a cane only short distances at first. Avoid putting too much pressure on the ankle, since doing so might force the already damaged ligaments farther apart.
To help protect against another sprain, buy supportive footwear such as sandals and low heeled shoes. Wear thick soled tennis shoes instead of thin ones. Try walking barefoot on grassy areas. Keep your toes flexed and avoid long steps. Stretch before exercise.
You’ll want to stay off your ankle as much as possible during the first two weeks. For the next four weeks, limit activity to gentle stretching, walking, icing, and light range of motion. During this period, you may need to see a doctor who’s trained specifically in treating ankle injuries. He or she will evaluate how your ankles look and feel and whether you’ve recovered to the point where you can return to your normal activities. Your doctor will discuss your condition with you, including any restrictions you may face.
If you have severe bruising, swelling, deformity, weakness, numbness, or tenderness, consult your physician immediately. These symptoms indicate a serious fracture or dislocation, and immediate treatment is required. Fractures in the distal part of the fibula (the tip) are the most likely to require surgical repair.
After the initial two-week phase, you can begin exercising your ankle. However, you should always check with your doctor before beginning any new exercise program. Exercises can increase blood flow to the injured area, which might make it swell even more. They also help restore muscle strength and coordination. Some types of ankle exercises are listed here. Before starting them, talk to your doctor or physical therapist:
Stretching. Stretching exercises are helpful for increasing flexibility. Begin slowly with stretches that take five minutes or less. Increase the number of repetitions over time. Also, stretch for 15 seconds each side, then switch sides. Gradually increase the length of time you spend stretching. Hold each stretch for 30 seconds, repeating twice on each side. Then stand for 60 seconds. Repeat once more.
Walking heel raises. Stand facing forward, holding onto something firm (such as a chair back) for balance. Raise heels upward toward ceiling using both calf muscles. Slowly raise heels 3 inches (8 centimeters) per step. Walk heel-to-toe, taking eight steps per minute. Do 20 repetitions every other day. Over time, increase the height of raised heels.
Squats. Sit on the floor with legs extended straight ahead. Keeping upper arms parallel to the ground, lift buttocks slightly off the floor. Lower hips as far as comfortable, letting knees bend naturally. Rise up and down several times. Hold each movement for 15 seconds. Repeat twice daily. Gradually work up to 10 sets.
Lunges. Step forward with right foot, bending left knee 90 degrees. Bend right knee until it nearly touches the ground. Push yourself up with your hands. Alternate legs. Start with 10 lunges, then gradually increase to 25 per session.
Strengthening. Strengthening exercises improve ankle stability and control. Be sure to have someone spot you and provide positive reinforcement throughout. Start slow with simple movements, such as leg lifts and squats. Work up to 10 repetitions of each exercise.
Doing strengthening exercises increases the risk of reinjury. Always finish with rest periods of five to ten minutes of sitting or lying down. Take frequent breaks.
Returning to strenuous activities. After two weeks of recovery, you should be ready to participate in moderate aerobic exercise. Two months later, you can resume running, biking, hiking, playing basketball, and similar activities. As soon as you feel confident doing so, try jogging in place or walking a few blocks.
Continue following your doctor’s advice for six weeks after returning to strenuous activities. Even when your ankle appears healthy, continue wearing protective gear like athletic gloves and helmets. In addition, consider buying special equipment designed to prevent injury. Some devices, such as the FitSteps pedometer, measure the amount of impact exerted on the ankle during everyday tasks. Other products, such as the Balance Trainer, alert you to changes in your gait caused by abnormal swaying.
For more information on ankle sprains, see the links on the following page.
Injured ankles heal best when given adequate nutrition. Make sure your diet includes plenty of complex carbohydrates, such as fruits, vegetables, whole grains, and dairy products. Drink lots of fluids. Eat foods containing vitamin C, such as oranges. Avoid caffeine, alcohol, tobacco, and drugs that alter your mood and sleep patterns.
Your doctor may prescribe anti-inflammatory medications, such as ibuprofen, naproxen, and aspirin, to relieve discomfort. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as indomethacin inhibit prostaglandins, chemicals that attract white blood cells to inflamed tissues. Ibuprofen relieves inflammation primarily through inhibiting cyclooxygenase enzymes. Naproxen inhibits both COX-1 and COX-2. And aspirin works by blocking COX-1. Although NSAIDs can decrease pain and swelling, they don’t speed healing or diminish scar formation. Continue using ice and compression bandages for stiffness and swelling. Ask your doctor about alternative treatments, such as acupuncture, massage, and chiropractic care.
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