Ankle Aid

An increase in outdoor activity sometimes means an increase in injuries, including those to the foot and ankle. Walking or running on uneven surfaces such as trails or river bottoms increases the risk of ankle injuries involving tendons, ligaments, or bones.

I see ankle injuries on a daily basis. These injuries affect all age groups and are often the result of “rolling” the ankle during a sports activity or even just taking a wrong step. Two of the most common ankle injuries are ligament injuries (sprains) and bone injuries (fractures).

According to the American Academy of Orthopaedic Surgeons, about 25,000 ankle sprains occur every day! That’s a lot of sprains, but most people aren’t even exactly sure what an ankle sprain really is.

The ankle joint is held in place by fibrous structures called ligaments. These ligaments hold the ankle bones in position and keep the ankle stable for activities. When an abnormal motion (twisting or rolling) occurs, the ligaments stretch beyond their limits and tear. In a severe sprain, the ligaments tear completely—sometimes causing a popping sound or feeling. As you can imagine, torn ligaments are swollen and painful enough that crutches are often needed to get around.

To diagnose an ankle sprain, you need a physical exam. Your doctor may even order an x-ray to rule out a fracture. Treatment of an ankle sprain includes rest, ice, compression, and elevation (abbreviated to RICE). In addition, you may need physical therapy to help decrease pain and swelling, prevent chronic ankle problems, and get back to normal. Crutches, ankle braces, or removable cast boots can be very helpful at keeping you mobile while recovering. Most ankle sprains, if treated, will resolve in about six weeks. If symptoms persist beyond that, your doctor may recommend an MRI. Sometimes, persistent instability requires surgery.

Ankle fractures, though less frequent, are still very common. Just like a sprain, a fracture results from a twisting injury. Unlike an ankle sprain, however, the ankle twists farther than the joint architecture allows, which fractures the ankle bones. That's why if you have a painful swollen ankle after an injury, your doctor may recommend an x-ray.

An ankle can be fractured in many ways, but a fracture usually involves one or more of three bones: the medial malleolus, the lateral malleolus, or the posterior malleolus. Treatment of varies from immobilization in a walking cast boot to surgery.

Avoiding Injury
According to the American Orthopaedic Foot and Ankle Society, the best way to prevent ankle injuries is to warm up before vigorous activities and maintain good strength, muscle balance, and flexibility. Also, pay attention to surfaces. Wear good shoes. Pay attention to your body, and slow down when you are fatigued or in pain.

Dr. Jon Robinson is a foot and ankle specialist in the Gallatin Valley.