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Sprained Ankle

Ankle sprains can be divided into 

Ankle sprains can be divided into two different groups, complicated and uncomplicated. Uncomplicated ankle sprains are usually treated without surgery; they include injuries not associated with fractures. Complicated ankle sprains are the ones that usually require surgical treatment.

Diagnosis

All ankle trauma is evaluated with your history in mind (situation and mechanism of injury, previous injury to the joint, and any other damage that may have occurred) and a careful physical examination (for example inspection, palpation, weight-bearing status). Tests would include an x-ray and diagnostic ultrasound. If you have pain lasting more than six weeks, computed tomographic (CT) scanning or magnetic resonance imaging (MRI) should be considered to make sure there isn’t greater injury.

Initial Management

Increased swelling is directly associated with the loss of range of motion in an ankle joint, therefore the initial goals are to prevent the swelling from occurring so that you can maintain an acceptable range of motion. An early management technique would be RICE (Rest, Ice, Compression, and Elevation). Cryotherapy is an option that should be used immediately after the injury occurs. Heat incidentally should not be applied to an acutely injured ankle joint as this would encourage swelling and inflammation through hyperemia. Compression Below Knee casting may be utilized to prevent long term chronic instability to the ankle. For great structural ankle joint integrity you should maintain minimum immobilization for at least 10 days. An injured extremity should be elevated to between 15 and 25 cm’s (6 to 10 in.) above the level of your heart to facilitate venous and lymphatic drainage until swelling has subsided. Some patients might even be eligible to use crutches depending on the severity of the injury.

Functional Rehabilitation

Proper rehabilitation after an ankle sprain is of the utmost importance and cannot be undervalued, especially when the consequences could leave you debilitated with decreased ranges of motion, persistent pain and swelling, or chronic joint instability. After your initial treatment, a rehabilitation regimen is a pivotal way to a speedy return to activity and also to prevent chronic instability. The four components of rehabilitation are range of motion rehabilitation, progressive muscle strengthening exercises, proprioceptive training, and activity specific training. A prerequisite to the institution of functional rehabilitation is ankle joint stability. Ankle sprains should never be taken lightly and you should always look to prevent chronic instability and discomfort.

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