â€œStrugâ€gling Through an Ankle Injury
With the Summer Olympics fast approaching I remember one of the greatest and most memorable Olympic moments in history. For the 1996 US women’s gymnastics team to have a chance at gold, little Kerri Strug would have to nail her vault. The unthinkable happened as Kerri completed her first of two vaults; she fell while landing, ripping ligaments in her ankle. She then ignored her injury and stuck the landing of her second vault. Who can forget her collapsing to the floor in pain after securing the American team its first ever Olympics gymnastics gold?!? Kerri Strug went on to become one of the most recognizable faces of the 1996 games. What a great ending, right? Well, if this really was the end of the story, it would be. But it wasn’t.
In 1997 Sports Illustrated wrote about Strug, “A year after her Olympic vault to fame, Kerri Strug now carries herself stiffly and walks with a trace of a limp. Physical therapy took a backseat to making appearances.” A lot of people are like Kerri Strug and see a sprain as a minor injury that they can struggle through without treatment. They don’t take time out of their busy lives to treat the injury, and they end up paying for it later. This time of year is the height of the ankle injury season at Advanced Foot and Ankle Care, and we have all of the experience, diagnostic and treatment tools to get you back on your feet and enjoying the rest of your summer.
To understand how to adequately treat an ankle sprain first we should start at the beginning and understand the injury itself.
Anatomy of an Ankle Sprain:
The ankle bones are held in position by ligaments. The ligaments protect the ankle against abnormal movements like twisting, turning, and rolling of the foot. Ligaments are elastic within their limits, but when they are forced beyond their normal range, a sprain occurs. Sometimes the ligaments even tear, and you may hear a popping sound. Pain and swelling soon follow. Sprains are given grades 1, 2, and 3, increasing in pain and swelling along with ligament injury from stretching to complete rupture.
Diagnosing the Sprain:
The first step in treating an ankle sprain is properly diagnosing it. At Advanced Foot and Ankle Care we have several techniques to properly diagnose ankle injuries. The most important technique we employ is the history and physical examination. By listening to our patients’ mechanism of injury and examining their injured foot and ankle we usually have a good idea of what we’re dealing with. We also take x-rays to rule out a break in the bones. The diagnostic ultrasound machine is often used to evaluate tendons and ligaments for ruptures and tears. It’s also possible that an MRI might be ordered to confirm our diagnosis if we suspect injury to the joint surface, a small bone chip, or a very severe injury to the ligaments and tendons.
Treating the Sprain:
We treat ankle sprains based on their severity or grade.
Grade 1 sprains should be treated with rest using a special boot called a CAM boot, icing, a compressive wrap, and elevation. After a patient has healed enough that a CAM boot is no longer necessary they may find a non-custom brace helpful as they transition back into normal physical activity.
Grade 2 sprains are again treated with rest using a CAM boot (possibly with the addition of an assistive device such as crutches), icing, compressive wraps, elevation, non-custom bracing, and physical therapy. Physical therapy is an invaluable part of treatment to regain strength and range of motion after ankle injury. Adequately rehabilitating an ankle sprain goes a long way toward preventing reinjury to the ankle.
Grade 3 sprains may be treated the same as Grade 2 sprains but could possibly require surgical repair. Physical therapy is of even more importance in these high grade injuries, and a custom brace may be helpful for walking on uneven surfaces or performing sporting activities that require sharp, sudden turns (cutting activities) like tennis, basketball, or football.
Healing an ankle sprain can take as long as healing a broken ankle bone. Lower grade sprains usually take 4-6 weeks to heal, and higher grade sprains can take months to feel back to normal. It may even be several months before you are able to return to sporting activities. 40% of those with acute ankle sprains will develop chronic symptoms of ankle dysfunction such as pain, swelling, recurrent injury, and weakness. The healing process can be slow, but it’s so important to be patient and seek the proper treatment to avoid these problems.
Hillarie Amburgey, DPM