Common Injury: Ankle Sprains

One of the most common problems presented to primary care clinics is ankle sprains. Sprains can happen when you overstretch or twist a muscle. This is especially if you skip warming up before exercising. Fortunately, after 2 weeks, most people will recover from ankle sprains on their own. 

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Is it an Ankle Sprain?

A sprain is when you have torn or twisted your ligament (the tough bands of tissue around the joints that connect your bone to one another). You would feel that the injured ankle is swollen or bruised and you cannot put weight on that injured ankle without feeling pain. You might also find it hard to move the foot in certain directions if you have an ankle sprain. Sometimes, the doctor might also use an ultrasound to look at the ligaments to confirm if it is an ankle sprain or not. 

How to Treat Ankle Sprains?

RICE Approach 

The immediate way to manage ankle sprain would be the RICE approach. RICE stands for 

1. Rest: Avoid weight-bearing activities until you have recovered from the sprained ankle.
2. Ice: During the first 48 hours of sprain or until the swelling subsides, you can apply a cold compress to the affected area. It is recommended to apply for 15 to 20 minutes every 2 to 3 hours during your waking hours. The earlier you start your cold compress, the more effective it will be. 
3. Compress: Apply an elastic bandage to the sprained ankle. This provides support and protection. Compression (applying pressure) with the elastic band also helps to minimize swelling. 
4. Elevate: You should elevate your injured ankle. If possible, keep your legs above the level of the heart. During sleep, you can place the injured leg on a pillow. When you are awake, you can put the injured leg on a chair. This would help to reduce swelling. 

Pain-Relieving Medications 

You can buy over-the-counter medications like acetaminophen (more commonly known as paracetamol). These medications can help to relieve the pain you experienced due to the sprained ankle.

There is also another category of medication that has dual functions. These medications called non-steroidal anti-inflammatory drugs (NSAIDs, in short) can help with pain relief and can also help to reduce the inflammation in your ankle. Some examples include diclofenac, ibuprofen, and ketoprofen. Depending on your preference, you can choose between different formulations, including oral tablets/ capsules, patches, or even topical gel. If you choose the oral tablets, remember to take them after food to reduce the stomach discomfort from the NSAIDs. 

Physical Therapy 

Once the acute pain and the swelling subsides, it is important that you engage in simple physical exercises. Start low and slowly increase the intensity of rehabilitation. This is to ensure that you maintain some sort of motion at your ankle, especially if you have been on ankle splints or braces for some time. However, do be careful not to overexert and protect yourself against reinjury. One common exercise you can start with is foot circles.

Figure 1: Foot circles

How to Prevent Ankle Sprains?

Firstly, you can consider external ankle support or ankle guards when exercising, especially if you have sprained your ankle before and are prone to reinjury. 

Secondly, you can also do a simple training exercise about 2 to 3 times a week. Each training session takes about 15 minutes. 

• Close your eyes and perform a single-leg barefoot balance for 30 seconds on each leg. Do a total of 1 to 2 sets. 
• Do single-leg heel raises for 15 times on each leg. Complete a total of 1 to 3 sets. 
• Do step-back or reverse lunges for 15 times on each side. Do a total of 1 to 3 sets. 
• Do side-to-side shuffles for 5 minutes.

This simple training exercise can be done by anyone, including those who do recreational sports.  

Conclusion 

Most ankle sprains, especially if mild, can be self-managed. However, if your sprain is taking longer than usual to get better, or if the injury is getting worse even after RICE therapy, it is important to visit a primary care clinic to get your ankle checked. If your ankle looks crooked or you suspect there is a fracture, do visit an urgent care center for an X-ray to rule out a fracture.