By Janson Holm, DPM, FACFAS, foot and ankle
Most people can remember a time when they sprained their ankle: you’re walking along and step off the edge of the sidewalk, or turn your foot on an unseen tree root or pinecone. Without time to react, your ankle folds under your leg and down you go.
This injury goes by many names: “I sprained (or strained, turned, wrenched, dislocated, rolled, twisted or inverted) my ankle!” The result of the injury can range from no issues at all to the beginning of chronic problems with ankle pain and instability.
60% of ankle sprains resolve with RICE
By the numbers, about 60% of all ankle sprains will resolve with simple treatments including rest, ice, compression and elevation (RICE). The other 40% are likely to have some degree of residual pain, instability and altered sensation — all of which increase the risk of repeat sprains. This becomes a slippery slope, as each subsequent sprain magnifies these problems and increases the likelihood that you’ll sprain the ankle again.
In the long run, altered sensation and instability of the ankle will cause irreversible ankle arthritis in about 20% of ankle sprain patients. The good news is that our current treatments can reduce the likelihood of irreversible arthritis if the problem is detected early and treated appropriately.
What to do if you sprain your ankle
An ankle sprain is a stretching or tearing of ligaments — bands of tissue that connect bones and joints —across the ankle. Ankle sprains also can cause other problems that include fractures, tendon tears, and cartilage injuries that can damage the surface of the joint.
Rewind back to stepping off the edge of the sidewalk: your ankle folds under your leg, you might hear a pop, and you feel pain as you fall to the ground. What should you do?
Take a moment to assess the situation. Did you hurt anything else in the fall? Does the ankle look normal? If you injured other body parts or if the ankle looks out of position, get help and see a doctor right away for further evaluation.
If you don’t feel that you have injured anything else, and the ankle looks normal, make an attempt to get up and walk. If you can walk without causing severe pain, get yourself home and start RICE treatments. If your ankle is improving quickly under these treatments, you are probably in the 60% of these injuries that will resolve uneventfully.
However, if you can’t walk without having disruptive pain, you should have the ankle evaluated by a doctor. Evaluation early in the process can lead to treatments that reduce the risk of long-term problems.
Help for repeat ankle sprains
If you are in the category of patients who’ve had numerous ankle sprains in the past, and you have ongoing ankle pain or a feeling of ankle instability, it’s a good idea to see a foot and ankle specialist for further evaluation. Non-invasive treatment involving bracing and physical therapy may help you protect and strengthen the ankle.
For ankles that have continuing problems, magnetic resonance imaging (MRI) is usually needed to evaluate the ankle for other areas of damage. Based on what the MRI reveals, your care team might recommend surgery to repair damage, create a more stable ankle, and prevent the development of ankle arthritis.
As a specialist in evaluating and treating ankle injuries, from mild sprains to complicated fractures, I am part of your team at The Portland Clinic. As a surgeon, I consider each situation individually and provide appropriate solutions — both non-surgical and surgical — to address problems. My goal is the same as yours: to help you achieve and maintain proper function of your ankle for the long run.
