Spraining the ankle, or ankle joint, is a common injury. It can force you to give up sports or wearing high-heeled shoes. An ankle sprain may also require surgery. Find out about the symptoms of an ankle sprain, how to help yourself, and how to treat it.

Every yearan ankle sprainhappens 360,000 Poles. This is by far the most common injury for which we report to an orthopedist.Sprain of the ankle jointconsists in exceeding the physiological range of motion in the ankle joint, which leads to damage to the articular capsule and ligaments. As much as 95 percent. of cases, it is a foot curl over the outer edge, in 5 percent. to the inner one.

From bandaging ankle to plaster

Sprains of the ankles do not always require the help of an orthopedist. This depends on the severity of the injury (see box).

  • 1st degree

We can deal with the 1st degree ourselves. Treatment consists of applying cold compresses, resting, minimizing walking, stiffening the ankle with an elastic band or bandage.

  • 2nd degree

In the case of grade II, it is better to go to an orthopedist. The treatment consists of using gel preparations with analgesic and anti-inflammatory properties (e.g. Elmetacin (spray), Fastum, Voltaren, Ketonal, Dip Rilif), anti-swelling (Aescin, Reparil Gel N, Altacet) and wearing a stabilizer with side stiffeners. It immobilizes the ankle joint (prevents the foot from bending sideways).

If the pain significantly restricts the ability to move, the doctor also recommends injections of heparin, as in the case of a plaster cast, as part of anticoagulant prophylaxis. Proper, early specialized ankle rehabilitation is also extremely important.

  • 3rd degree

In grade III, either a plaster dressing is used for 2-3 weeks and a stabilizer for the next 3 weeks (it is worn around the clock), or the orthopedist recommends putting on a stabilizer immediately. Studies show that both treatments are effective. Nevertheless, it is better to put on a cast immediately after a sprain, because this kind of immobilization of the joint relieves the pain faster andprevents the injury from worsening.

Worth knowing

Three Degrees of Twisting

  • 1st degree - slight stretching of the bag and ligaments. The pain is slight, it slightly interferes with walking. A small swelling that subsides quickly appears. The hematoma is absent. There is no feeling of instability in the joint.
  • 2nd degree - partial rupture of ligaments and capsule. Pain makes it difficult and often impossible to walk. The swelling is considerable and there is also a hematoma. A slight instability of the ankle may be felt.
  • 3rd degree - complete rupture of ligaments and capsule. The pain, paradoxically, may be less at the time of injury than for stage II, but much greater when walking. It can make it impossible to load the diseased foot at all and force you to move on crutches. The swelling and hematoma are large. There is instability in the joint.

Sprained ankle and chronic ankle instability

The result of rupture of the joint capsule, rupture or rupture of ligaments, even with proper treatment, can be chronic instability of the ankle joint. It happens that the joint capsule and ligaments are too loose after fusion. So they don't hold the pond as it should. Then the risk of twisting your ankle again increases in certain situations, such as when walking in high heels, over uneven terrain or on soft ground (beach). Subsequent injuries are usually less painful, but lead to joint wear and degeneration.

A sprained ankle can have other consequences as well. It happens that fragments of cartilage or talus break off, which may result in chronic pain and swelling in the future due to wedging of such fragments between the articular surfaces. The source of ailments is also synovial hypertrophy (the inner lining of the joint capsule).

In the case of chronic instability of the ankle, specialized rehabilitation may improve. It includes strengthening the peroneal muscles and exercises to improve the so-called prioprioception, or deep feeling. Thanks to it, the body knows that we have placed our foot on uneven terrain and therefore immediately tenses the appropriate muscle groups. This reaction prevents the ankle from twisting. However, after a third degree injury, it is slower and weaker due to damage to the nerve endings in the joint capsule and ligaments, therefore rehabilitation is needed.

Important

Sprain vs sprainSprain and sprain are two different injuries. The latter is the loss of contact between the articular surfaces of the talus and tibia. They move relative to each other and the pond is theredistorted. Dislocation requires immediate medical attention - joint adjustment, and sometimes also urgent surgical treatment.

Sprained ankle: operation

Sometimes it is necessary to surgically treat chronic instability of the ankle joint, which usually consists in strengthening the ligaments by duplicating the joint capsule. It is cut, folded over itself to make it tighter, and sewn together. This shortens the ligaments that are part of the capsule. In some cases, this is not enough and you need to transplant tendons from another part of the body to reconstruct the ligaments. Such operations are performed under spinal anesthesia (from the waist down). The procedure takes 1-1.5 hours. If it is combined with arthroscopy (necessary in the case of suspected synovial hyperplasia or a free body, e.g. a piece of cartilage, within the ankle joint), the time is extended to 2 hours. After the operation, the leg is immobilized in a cast for 6 weeks, and a brace is worn for the next 1.5 months. During this period, rehabilitation is recommended. After about 3 months, you can return to your usual lifestyle, play sports and … your favorite high-heeled shoes.

Important

Before you go to the orthopedistAfter spraining the ankle, cool the injured area as soon as possible with a cold compress or spray with a cooling spray to relieve pain and prevent edema and hematoma. Keep your leg movements to a minimum. It is best to sit with your foot in a chair or lie down. You also need to immobilize the ankle with a bandage or elastic band. If the injury was minor, the ailments will disappear quickly and an orthopedic visit will not be necessary.

Thrombotic prophylaxisIt should be used for ankle sprains, which are associated with a significant reduction in physical activity. The most common indication for the administration of anticoagulant heparin injections is the immobilization of the leg in a plaster cast. Such prophylaxis is also used in the case of a stabilizer, if severe pain makes it impossible for the patient to move. The risk of a blood clot is then increased.

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Spine, bones, joints