Editor’s note: This is the first story of a monthly series featuring common sports injuries. Every month, Dr. Dena Florczyk from the Arthur Ashe Student Health and Wellness Center, will discuss a specific common sports injury – how it occurs, the diagnosis and treatment options.
Ankle injuries are some of the most common musculoskeletal injuries seen in both the primary care office and the emergency department. Active UCLA students, especially those who participate in exercise or sports that involve side-to-side movement, such as basketball, football or soccer, might experience an ankle injury.
The most common acute ankle injury is an ankle sprain, which results from an injury to one or more ligaments of the ankle. The ligaments are tough bands of tissue that connect bone to bone and provide stability. An ankle sprain occurs when the ankle joint turns too far in a particular direction, causing the ligaments to be stretched out, partially torn or completely torn.
There are three types of ankle sprains: lateral, medial and high ankle sprain. The majority of ankle sprains are lateral sprains caused by an inversion injury (i.e., rolling of the ankle), which damages the ligaments on the outside of the ankle. Symptoms of an ankle sprain can include pain, tenderness, swelling and bruising.
If it is a severe sprain, weight bearing may be difficult. The severity of the sprain is graded on a scale of I (mild) to III (severe) based on the degree of the ligament tear, loss of functional ability, swelling, pain, bruising and difficulty bearing weight.
In general, early treatment recommendations over the first two to three days consist of protecting and resting the ankle by limiting weight bearing, applying ice for 15-20 minutes every 2-3 hours, compression with an elastic bandage to minimize swelling, and elevation above the level of the heart. Using an anti-inflammatory medication such as ibuprofen may help reduce pain and swelling.
Functional rehabilitation following an ankle injury is critical as inadequate treatment can lead to chronic problems such as decreased motion, pain and joint instability. Additionally, the most common risk factors for an ankle sprain are a history of a previous ankle sprain and the lack of adequate rehabilitation after a sprain.
In general, as soon as the pain subsides gentle range of motion exercises, such as making foot circles and calf stretching, may be performed. Muscle strengthening exercises may begin once pain allows and should include strengthening in all directions of ankle movement. This is followed by proprioceptive training (e.g., using a wobble board or Bosu ball) and finally activity-specific training (e.g., walking-jogging, jumping, cutting).
Over the first four weeks after the injury, pain and swelling tend to decrease, and there is some evidence that using an external support device (semi-rigid ankle support, lace-up ankle support, tape or elastic bandage) may reduce swelling, the time to return to sport, as well as the subjective instability.
Six to eight weeks after the sprain, the newly formed collagen fibers of the ligament can withstand almost normal stresses; however, full maturation and remodeling of the ligament may take up to six to 12 months.
After an ankle sprain, you should seek medical evaluation if you are unable to bear weight, if your ankle looks deformed or crooked or if you have instability in your ankle. You should also be evaluated if you suspect you have medial ankle sprain, high ankle sprain or have persistent pain after an ankle injury.