- Published on Wednesday, 17 August 2011 01:00
- Written by By Brad Naylor, DPM, M.S.
Ankle sprains are very common, and in many cases doctors diagnose them as minor sprains and tell patients they require no more than ice and mild compression.
This may not always be the best advice, however, and can even lead to long-term complications.
The majority of ankle sprains, commonly called “inversions” or “roll-out” injuries, are characterized by swelling, pain and varying degrees of bruising that resolve within a few days or weeks.
When patients feel the injury is severe enough to seek care in an emergency room or urgent-care clinic, most doctors order an ankle radiograph to rule out the possibility of a fracture or dislocation.
Once the ankle injury is diagnosed as a sprain, most patients are told to apply ice and mild compression and walk on the ankle as tolerated, and that the injury will heal within weeks. Unfortunately, however, many of these patients end up in my office – complaining that their ankles continue to feel unstable and as though they will “roll out” again.
We often find that the ankle sprain, diagnosed as minor, really involved severe tearing of soft tissues. In some cases, we also find that the ankle wasn’t properly immobilized with a brace or cast right after the injury. This can leave the injured ligament prone to being stretched during sleeping hours, when the unprotected foot or ankle is in a flexed or pointed position.
This can elongate the ligament, leading to chronic ankle instability. Left untreated, many of these patients endure persistent ankle injuries for months, or even years, after the initial injury.
These patients are also more prone to experience degenerative joint disease (arthritis) in the injured ankle or foot.
While there are many other causes of chronic ankle injuries – such as tendon tears and bone or cartilage injuries – the tearing of soft tissue is the most common culprit when it comes to chronic ankle injuries.
The best way to avoid chronic ankle problems is to properly immobilize the ankle right after the injury occurs – with a brace or cast that holds the ankle and foot in a neutral 90-degree position.
In very rare cases, surgery is required to repair severe ligament tears. An ankle injury can be painful, but the pain doesn’t usually need to last for months or years.
The key to successful, fast healing is getting a proper diagnosis and treatment right after the injury occurs.
Dr. Brad Naylor, a podiatrist at the Palo Alto Medical Foundation, is board certified in foot and ankle surgery by the American Board of Podiatric Surgery.
The Palo Alto Medical Foundation and editor Arian Dasmalchi provide this monthly column.