Dr. Brian Richman wrote this newspaper article for the Ogden Standard Examiner ( Lakeside Addition ) on July 25, 1999.
The ankle joint is comprised of the Tibia, Fibula, and Talus bones. Cartilage and synovial fluid help the ankle joint move smoothly. The ankle joint in conjunction with the achilles tendon acts like a hinge and allow the foot and ankle to move up ( Dorsiflexion ) and down ( Plantarflexion ). There are 5 strong ligaments on the medial or inside to the ankle compared to 3 weaker ligaments on the lateral or outside of the ankle which helps with ankle stability.
A sprain is a tearing of the tendons or ligaments that surround the joint. There are various grades of ankle sprains, and the severity of the sprain will determine the treatment. Ankle sprains are more likely to occur on the Lateral side of the ankle secondary to weaker and fewer ligaments than on the medial side. Inversion sprains are the most common and usually cause pain and swelling in the lateral ankle area. See Figure 1 for an anatomical drawing of the ankle joint.
Figure 1
Injuries from basketball, skiing, skating, snowboarding, hockey, and falls on the ice are common causes of ankle sprains in winter months. Other causes of ankle sprains include: stepping wrong on uneven terrain, falls from heights, stepping in holes, and injuries from football, soccer, rollerblading, and softball. Prevention of ankle sprains include high top tennis shoes, ankle braces while playing sports, being careful on icy surfaces, hiking boots while on uneven terrain, and avoiding areas that could cause potential problems.
A thorough history and physician examination by a trained physician in ankle care is needed to avoid chronic pain and edema, any permanent deformities, ankle instability, and / or any possible fractures. Sometimes soft tissue injuries (ankle sprain ) can take as long to heal as bone injuries (fractures). Early intervention and appropriate treatment for ankle sprains can restore ankle and foot function, increase range of motion, and reduce pain and swelling. All ankle sprains are not alike and should be treated on an individual basis.
Guidelines for treatment of ankle sprains include:
1. X-rays are most important to rule out fractures of the foot and ankle.
2. Rest - Patient may need crutches, walking cast, post op shoe, and / or fiberglass cast.
3. Foot elevated above heart level to reduce swelling.
4. Compression - Patient may need a Jones compression dressing, ace wrap, air casts and / or ankle braces to help with swelling.
5. Ice packs -Especially important the first 48 hours after injury.
6. Physical therapy - Whirlpool, contrast baths, range of motion exercises, Tens unit, ultrasound, ice,
7. Non Steriodial anti-inflammatory medication - Ibuprofen, Naproxen, Cataflam, Lodine, Daypro, Vioxx, Celebrex, etc. to reduce inflammation, swelling, and pain.
8. Analgesics - Pain medication may be needed on a short term basis.
9. Follow up visits - To assess progress of the ankle sprain, and adjust treatment as needed.
Dr. Brian Richman completed his undergraduate studies at Brigham Young University and is a graduate of the California College of Podiatric Medicine in San Francisco. Dr. Richman completed a 3 year surgical residency at the Veterans Affairs Medical Center and Doxey Hatch Medical Center in Salt Lake City, He is a member of the American Diabetes Association, American Podiatric Medical Association, and the Utah Podiatric Medical Association.
Dr. Richman specializes in diabetic foot care, foot and ankle surgery, biomechanics, sports medicine, and general podiatric conditions.
|
