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Ankle Sprain

Ankle rolled on a slope spraining ankle causing torn ligamentsAn ankle sprain is an injury to one or more ligaments in the ankle, usually on the outside of the ankle. Ligaments are bands of tissue—like rubber bands—that connect one bone to another and bind the joints together. In the ankle joint, ligaments provide stability by limiting side-to-side movement.

Some ankle sprains are much worse than others. The severity of an ankle sprain depends on whether the ligament is stretched, partially torn, or completely torn, as well as on the number of ligaments involved. Ankle sprains are not the same as strains, which affect muscles rather than ligaments.

What Causes a Sprained Ankle? 

Sprained ankles often result from a fall, a sudden twist, or a blow that forces the ankle joint out of its normal position. Ankle sprains commonly occur while participating in sports, wearing inappropriate shoes, or walking or running on an uneven surface. Basketball, soccer and trail running are some of the most sports that lead to ankle sprains. Sometimes ankle sprains occur because of weak ankles, a condition that some people are born with. Previous ankle or foot injuries can also weaken the ankle and lead to sprains. 

Signs and Symptoms 

The signs and symptoms of ankle sprains may include: 

• Pain or soreness 

• Swelling 

• Bruising 

• Difficulty walking 

• Stiffness in the joint 

These symptoms may vary in intensity, depending on the severity of the ankle sprain. Sometimes ankle pain and swelling are absent in people with previous ankle sprains—instead, they may simply feel the ankle is wobbly and unsteady when they walk. Even if you don’t have pain or swelling with a sprained ankle, getting the correct treatment is crucial. Any ankle sprain—whether it’s your first or your fifth—requires prompt medical attention. If you think you’ve sprained your ankle, contact your foot and ankle surgeon for an appointment as soon as possible. In the meantime, immediately begin using the “R.I.C.E.” method—Rest,Ice,Compression, and Elevation—to help reduce swelling,pain,and further injury. 

 

X-rays are Often Needed to Evaluate the Injured Ankle

Not every sprained ankle needs an x-ray.  In this video, Dr. Segler explains how ankle surgeons decide when x-rays are necessary.  

 

Why Prompt Medical Attention Is Needed 

There are four key reasons why an ankle sprain should be promptly evaluated and treated by a foot and ankle surgeon: 

  1. An untreated ankle sprain may lead to chronic ankle instability,a condition marked by persistent discomfort and a “giving way” of the ankle. You may also develop weakness in the leg. 
  2. You may have suffered a more severe ankle injury along with the sprain. This might include a serious bone fracture that could lead to troubling complications if it goes untreated. 
  3. An ankle sprain may be accompanied by a foot injury that causes discomfort but has gone unnoticed thus far. 
  4. Rehabilitation of a sprained ankle needs to begin right away. If rehabilitation is delayed,the injury may be less likely to heal properly. In evaluating your injury,the foot and ankle surgeon will take your history to learn more about the injury. He or she will examine the injured area,and may order x-rays, an MRI study,or a CT scan to help determine the severity of the injury.  

Non-surgical Treatment and Rehabilitation 

When you have an ankle sprain, rehabilitation is crucial—and it starts the moment your treatment begins. Your foot and ankle surgeon may recommend one or more of the following treatment options: 

Immobilization. Depending on the severity of your injury, you may need to protect the ankle in an ankle brace, fracture walking boot, or (in extreme cases) a short-leg cast to keep your ankle from moving. You may also need crutches depending on how bad the ankle is injured. 

Early physical therapy. Your ankle doctor will start you on an ankle rehabilitation program as soon as possible to promote healing and increase your range of motion. This includes doing prescribed exercises. Dr. Segler has these broken down for you in Phase I, Phase II and Phase III exercises.  He will walk you through these at your house call visit.

Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be recommended to reduce pain and inflammation. In some cases, prescription pain medications are needed to provide adequate pain relief.  Dr. Segler will write prescriptions for you if needed. 

Icing. You may be advised to ice your injury several times a day until the pain and swelling resolves. Wrap ice cubes, or a bag of frozen peas or corn,in a thin towel. Do not put ice directly on your skin. You can also view the video on the best way to ice a sprained ankle. 

Compression wraps. To reduce and prevent further swelling, you may need to keep your ankle wrapped in a multi-ayer compressive dressing that Dr. Segler will apply at your urgent ankle sprain visit. In some cases, an elastic bandage or compressive stocking can be used to keep the swelling down as you recover.

When Is Surgery Needed? 

In more severe cases, surgery may be required to adequately treat an ankle sprain. When surgery is needed, it often involves repairing the damaged ligaments or fixing broken bones that happen at the same time as the sprain. The foot and ankle surgeon will select the surgical procedure best suited for your case based on the type and severity of your injury as well as your activity level. After surgery, rehabilitation is extremely important. Completing your rehabilitation program is crucial to a successful outcome. Be sure to continue to follow-up with Dr. Segler surgeon during this period to ensure that your ankle heals properly and function is restored.  

When an ankle is sprained, the ligaments can stretch, partially tear, or completely tear. Without proper treatment, the ligaments will not heal correctly and cause long-term ankle instability, pain, and arthritis. Immediate treatments focus on decreasing swelling.  

(P.R.I.C.E)...

Protection: Wear an ankle brace or fracture walking boot that Dr. Segler provided for you at you ankle sprain house call. This will immobilize the injured ligaments, protect the ankle, and allow healing and recovery from the sprain, while allowing you walk.

Rest: Limit activities and use crutches if needed. Do walk on it without the brace if the ankle hurts.

Ice: Ice your ankle as soon as possible following the injury, use ice for the first 72 hours, 10 minutes out of each hour.

Compression: On old reliable remedy is to place an ace-wrap in 'Figure 8' around your ankle. As a more effective means of controlling the swelling, decreasing pain and speeding your recovery, invest in running specific compression stockings that will help solve the problem. You will also be able to put these to use later to speed recovery after exercise. Dr. Segler can also apply a multi-layered compressive dressing that functions as a soft cast and gets the swelling down quickly. 

Elevation: Keep your ankle above your heart. This will help reduce the swelling and pain. 

 

Recovery, Rehabilitation and Physical Therapy

Rehabilitation through physical therapy under the directions of a doctor with an interest in sports medicine is critical. Make sure your doctor is interested in getting you back to your desired activity level. You must both work together to develop a plan so you can reach your goals.  The good news is that in many cases, functional rehabilitation can get you back in action and sometimes in better condition than before the injury. Recovery is an active process. Dr. Segler only refers his patients to the very best physical therapists in the Bay Area.  In addition he calls and meets with these therapists to ensure that the entire team is working together with the common objectives of restoring you to full activity as quickly as possible. 

Emergency Appointments

Ankle sprains are painful and can severely limit you ability to walk, run, work and carry out the functions of a busy lifestyle. The fact is that the best treatment for an ankle sprain is immediate treatment. If you have an ankle sprain and live in the San Francisco Bay Area, we can see you the same day in your home or office.  If you need x-rays of your ankle, we can even arrange them to be taken at your home or office as well.  Don't sit around for weeks with a painful, swollen and bruised ankle. You can get treated today by San Francisco's award-winning ankle expert. 

 

San Francisco Ankle Sprain Patient Testimonial: "I highly recommend Dr. Christopher Segler at Doc On The Run. Dr. Segler looked at my badly sprained, and still swollen, ankle a week after I had been to acute care at UCSF, (where x-rays showed no broken bones, so they told me to stay off of it, gave me an ace bandage and sent me hobbling away). In a house call visit, he spent time listening to how I had sprained my ankle, did a thorough examination and explained in expert detail about my injury and what he recommended that I do next, so that I could heal as completely as possible. He is a true patient advocate and expert in his field. Knowing a doctor who I can trust completely for advice, who will return my phone calls promptly, and who believes in educating his patients, is invaluable. If you need a podiatric surgeon, sports medicine specialist or a honest second opinion, call Dr. Segler. He is the best!"   - Shona, San Francisco, CA. 

 

Dr. Christopher Segler is a sports medicine podiatrist and ankle surgeon who has won an award for his research on diagnosing subtle fractures involving the ankle. He offers house calls for those with ankle injuries who have a tough time getting to a podiatry office. If you have an ankle sprain and just have a question about whether or not it needs to be treated, you can reach him directly at (415) 308-0833.

 

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