1. What is the difference between a sprain and a strain?
A sprain is the stretching or tearing of ligaments, which are the
strong tissues that connect bone to bone across joints, such as
the ankle. A strain, often confused with a sprain, is a stretching
or overuse of muscles and tendons. A strain is often described as
a "tight muscle." Strains occur within the muscles when there is
not a significant amount of time given to stretching, or "warming
up," the muscle before activity.
2. What causes an ankle sprain?
Ankle sprains are the result of a sudden twisting and pressure on
the ankle. Sprains happen when normal range of motion in the ankle
is disrupted. They occur for several reasons but the most noted
are activities such as running on uneven pavement or stepping in
a hole, jumping and landing on someone's foot, playing basketball,
slipping on wet surfaces, wearing loose footwear or excessively
using a fatigued joint. Not listening to the body when it is tired
increases the chance for an ankle injury.
3. How can an ankle sprain be prevented?
Stretching before activity, strengthening the muscles of the lower
leg, and improving skills will help to reduce the risk for ankle
injury. This will also build strength within the joint. Strong muscles
will improve performance, reduce the risk of injury, and improve
range of motion. Learning proper technique for exercise will improve
performance and help prevent injury.
The following exercises should be completed wearing athletic shoes:
Range of Motion: A simple stretching exercise involves lifting
the foot in the air and "writing" the alphabet with the tips
of the toes. Hold the big toe rigid so that all motion comes
from the ankle.
Repeat exercise hourly, if tolerated.
Lift: Take a piece of rope about 1.5 feet long and tie a
5-pound weight to each end. Sit on a stool to allow the leg
to dangle and place the rope over the top of the toes. Use the
ankle to lift the weight as many times as possible.
Turn: While sitting on a counter, take a long piece of rope
and place it under the arch of the injured foot. Hold the ends
of the rope at about knee height. Slowly pull on the inside
of the rope while turning the ankle outward resisting the pull
of the rope. Alternate inward and outward movements until the
ankle is fatigued.
- Toe Raise/Heel Drop: Stand on a bottom stair or on a thick book with the
forefeet on the raised surface. Rise up on the toes above the
level of the stair or book, then return the heels below the level
of the stair or book, so that the back of the lower leg is stretched.
Lift and lower repeatedly, holding each position for 10-15 seconds.
Continue until the calf muscles become fatigued.
to these strengthening exercises, protective bracing or taping can
be effective at preventing ankle sprains in athletes. Most important
for the prevention of ankle sprains is realizing that fatigue and
pain are signs from the body to stop activity and rest.
4. How long does it take for the sprain to heal?
In ankle sprains
that are stable (no torn ligaments), activity can be resumed as
soon as pain and swelling subside and confidence in joint stability
returns. This can vary from a few days to a few weeks. When damage
to the ligament is more severe, healing may take from 5-8 weeks
following the injury. Following a severe ankle sprain, recovery
can take from 6-8 months.
5. Can the athlete return to his/her sport before treatment has been completed?
It is not recommended
that the athlete return to his/her sport prior to the completion
of rehabilitation. Athletes must gradually increase activity. The
chance for re-injury to the ankle is increased when recovery is
not complete. Re-injury to the ankle will limit healing so that
strength in the joint may not fully return to the pre-injury state.
When treatment is completed, physicians recommend supporting the
ankle by taping or using a re-usable lace-up brace for at least
6 months following injury.
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