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How to tell if your ‘ankle sprain’ isn’t just a sprain

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Ouch! We’ve all been there: you trip over something and sprain your ankle. Most of the time, it heals using the RICE method (“RICE” (Rest Ice Compression Elevation), and we’re back to normal in a few weeks. But what about those ‘sprains’ that have lingering or persistent symptoms for years following the injury? It may not be just a sprain after all. Here’s how to tell the difference.

sprained-ankle

 

What is an ankle sprain?

Ankle sprains are the most common musculoskeletal injury treated by primary care doctors and urgent care centers. These injuries typically involve the ligaments on the outer or lateral aspect of the ankle when the foot is forcefully inverted or twisted under. There are two primary ligaments that stabilize the lateral ankle. When excessive load is placed, and the ligaments are stretched beyond their capacity they begin to fail and tear. Depending on the severity of the disruption these injuries can vary in severity from a mild brief annoyance to a more severe problem.

What is considered more severe than an ankle sprain?

Fortunately, most ankle injuries are less severe and respond to standard treatments such as “RICE” (Rest Ice Compression Elevation). However, small percentage of ankle sprains do not improve as expected despite reported negative X-Ray’s (those X-Rays which do not indicate broken bones or fractures). A delay in treatment often occurs due to expectations of further improvement due in part to reported negative test results.

Typically, patients present months or years after a “sprain” with persistent symptoms that may include recurrent ankle swelling and pain after activity, chronic pain, and symptoms of instability including difficulty with uneven surfaces, repeat sprains, and chronic brace dependency.

An evaluation from a board certified orthopedic surgeon would include a history of the injury and treatment received to date, updated X-Rays, a careful exam looking for abnormalities which may include swelling, tenderness, weakness, nerve dysfunction, and ligament instability. An MRI exam may or may not be necessary.

The more common diagnoses found in patients reporting persistent problems following what was thought to be a common sprain may include occult fractures, a bone chips, ligament insufficiency, and tendon tears.

Treatment options

Treatment will of course vary depending on the diagnosis. Some injuries may respond to activity modification, physical therapy, stretching, strengthening, bracing, medication, or injection. Other injuries may require outpatient microsurgery or mini-open repairs. If surgery is needed, it is frequently performed on an outpatient basis with patients heading home the same day. Most painful ankle ailments are amendable to treatment with good outcomes.

The best outcomes follow an accurate diagnosis and focused treatment. To obtain an accurate diagnosis of your ankle condition make an appointment with a board certified orthopedic surgeon and get back in the game!


Call us to make an appointment: 631-423-BONE (2663) 

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Orthopedic doctor conveniently located near Nassau & Suffolk Counties in Long Island, NY