Both in and out
of sports, a sprained ankle is the most common of all joint injuries. Indeed,
the ankle seems to have a penchant for spraining. The main reason is that it is
a ginglymus—in other words, a hinge joint which, anatomically, doesn't allow
for much play. Furthermore, it is called upon to support the entire weight of
the body. So long as this weight remains fairly equally distributed, the ankle
absorbs strain and stands up comfortably. But when the weight unexpectedly and
violently shifts, the ankle has to give, and often a sprain results.
ankle is twisted, the immediate concern is to figure out the position of the
foot when the injury occurred. This may determine right off the extent of
damage and whether or not it is serious. If the foot twisted inward—as is most
commonly the case—the ligaments on the outside of the ankle usually have been
pulled (above), and this, while painful, is not always serious. But if the foot
turned outward, it is possible that a bone was broken. Since both a sprained
ligament and a fractured bone cause immediate pain, redness and, finally,
swelling, the foot-position becomes all-important, along with an X-ray if there
is any doubt, for selecting the best manner of treatment.
There's an old
saying that "a sprain is worse than a fracture," and this is all too
often true. Not that the results are any worse. Rather, a sprain, if treated at
all, is treated more casually. First aid should be to elevate the foot and
apply ice or cold to control the swelling. This should be followed, the next
day or so, by heat and massage. Moreover, the weakened joint should be braced
with a supporting bandage, a technique to be discussed in a later issue.
Depending on the extent of the sprain, you can count on four to 10 days before
it is back to normal. Meanwhile, exercises should be begun as soon as possible.
Start with a simple one: hold onto a chair and rise up on the balls of the feet
six times. Then work up to balancing on the affected leg without support,
walking tiptoe across a room, skipping, and finally trotting. These exercises
also build up chronically weak ankles.
As for walking
or playing on a twisted ankle, if the sprain is the common mild variety, there
is no harm, provided you take it easy. The joint, however, will feel more
painful the next day and may take longer to heal than if you lay off and give
it a deserved rest.
ligaments most commonly sprained when the foot twists inward are the lateral
collateral ligament (1) and the anterior tibiofibular ligament (2), which holds
together the bones of the leg, the tibia (3) and fibula (4). Rupture of tiny
blood vessels causes redness and swelling.