A sprained ankle is one of the most common injuries, it consists of tearing or stretching the ligaments that support the joint. Most sprains occur in the anterior talar peroneal ligament, as it is located on the outer side of the ankle. The external ligaments are not as strong as the internal ones; in some cases, body weight, gravity, and movements that apply excessive forces can stretch the ligament beyond its normal capacity; all this causes them to stretch and rupture the small surrounding blood vessels. You can think of a sprain as a rubber band that has been overstretched, with the result that its fibers have partially torn and the structure has become unstable.
Steps
Part 1 of 3: Check the Ankle
Step 1. Think back to the time of the injury
Try to remember what happened; it may be quite difficult to concentrate on what has happened, especially if you are in great pain. However, it is important to understand the dynamics of the accident as it offers many clues.
- How fast were you moving? If you were moving very fast (for example, skiing or running hard), then chances are you broke a bone and you need to go to the emergency room. A slow speed injury (your ankle has lost stability while jogging or walking) is likely a sprain that can resolve on its own with the right care.
- Have you experienced a sensation similar to a laceration? In most cases, it would indicate a distortion.
- Did you hear a pop or a "pop" sound? This is a phenomenon that patients often report in cases of sprains, although it can also occur with bone fractures.
Step 2. Look for swelling
When the ankle has been sprained, it usually swells immediately. Compare your ankles by placing them close to each other and see if the injured one is visually wider. Pain and edema are common symptoms in both sprains and fractures.
A deformity of the foot or joint definitely argues in favor of a fracture. Walk on crutches and go to the hospital right away
Step 3. Check for a hematoma
When the ankle has been sprained, the tissues are dark and bruised; check the joint to see if this is the case for you.
Step 4. Pay attention if you have pain to touch
In cases of sprain, the ankle hurts at the simple touch; to check it just place the fingers of the hand on the joint.
Step 5. Try to put some weight on the affected foot
Stand upright and try to transfer some of your weight to your ankle; if you feel pain, it could be broken or severely dislocated. Go to the hospital immediately (using crutches if possible).
- Check if the joint is unstable and "staggers". When the ligaments are stretched, there is a feeling of instability and insecurity in the ankle.
- In severe cases, it is impossible to put your foot on to stay upright or put some weight on it. Actions of this kind cause intense pain that necessitates the use of crutches and a visit to the emergency room.
Part 2 of 3: Assessing the Severity of the Distortion
Step 1. Recognize a first degree sprain
This type of injury is classified into three categories based on the severity of the damage. The first category, the least serious, is the one that includes first degree distortions.
- In this case, the strain of the ligament is minimal and does not interfere with the ability to stand or walk. Although the patient feels some discomfort, he is still able to use the joint in a normal way.
- A first-degree sprain causes mild pain and swelling.
- This type of injury and related swelling resolve spontaneously within a few days.
- In this case, self-medication techniques are enough.
Step 2. Distinguish a second degree sprain
In this case you are facing an injury of moderate severity: the ligament has been torn in an incomplete, but consistent way.
- A second degree sprain prevents the patient from using the ankle normally and is unable to put weight on it.
- The pain, swelling, and hematoma are moderate in severity.
- The joint is unstable as if it has been pulled in some way.
- Second degree sprains need to be treated by a doctor, plus the patient needs to use a brace and crutches for some time.
Step 3. Identify a third degree sprain
In this case the ligament is completely torn and has lost its structural integrity.
- The patient is unable to stand without help and cannot even place his foot on the ground.
- The pain is intense and the swelling is very pronounced.
- The tissues around the fibula are very swollen (more than 4 cm thick).
- The foot and ankle may be visibly deformed and there is a high risk of a fibula fracture just below the knee, which must be evaluated by an orthopedist.
- A third-degree sprain needs immediate medical attention.
Step 4. Recognize the signs of a fracture
In this case the injury involves the bones, which are broken, which is very common when the accident occurs at high speeds (involving a healthy person) or due to a simple fall when the victim is an elderly person. Symptoms often overlap with those of a third degree sprain. In this case, x-rays and medical attention are required.
- A fractured ankle is very unstable and painful.
- At the moment of trauma the victim can clearly hear a snap.
- The foot and joint are noticeably deformed; the foot may be at an unnatural angle, suggesting that it is a bone fracture or a severe dislocation.
Part 3 of 3: Curing the Distortion
Step 1. Go to the hospital
Regardless of the severity of the injury, you should always go to the emergency room to determine the best treatment, even if the damage does not seem serious but the pain persists for more than seven days.
- If you notice symptoms of a fracture or a severe sprain (second or third degree), go to the hospital without delay. In other words, if you are unable to walk (or are very difficult to walk), the limb is numb, the pain is very severe, or you have heard a snap at the time of the accident, you need to go to the emergency room. You need to undergo x-rays and an orthopedic examination to determine the most suitable treatment.
- Self-medication is only suitable for first degree sprains and sprains. However, if the joint doesn't heal properly, you may experience chronic pain and swelling. For this reason, even in cases of first degree sprain, it is worth contacting the attending physician as a minimum to determine the best therapy.
Step 2. Rest the joint
While waiting to go to the hospital or to go to your doctor, you can implement the first aid protocol called by the English acronym R. I. C. E (R. East, THEthere is, C.ompression, ANDlevation i.e. rest, ice, compression and lifting). For first degree sprains, this treatment is all you need and the first action to take is to rest the limb.
- Avoid moving your ankle and, if possible, immobilize it.
- If you have cardboard on hand, you can make a temporary splint to protect the joint from further injury. Try to lock the ankle so that it rests in its normal anatomical position.
Step 3. Ice the lesion
This way you reduce swelling and pain. Get something cold to put on your ankle as soon as possible.
- Gently apply the ice pack, but wrap it in a cloth first to avoid cold burns on the skin.
- A bag of frozen peas is also fine.
- Apply ice in 15-20 minute sessions every 2-3 hours. Keep this pace for the first 48 hours.
Step 4. Compress the joint
First degree sprains can be wrapped with an elastic bandage which increases the stability of the ankle and reduces the risk of further accidents.
- Band the joint by wrapping the bandage in a "figure eight" motion.
- Don't over-tighten the bandage, or you'll make the swelling worse. A bandage is good when it allows you to insert a finger under it.
- If you believe you have a second-degree sprain, follow your emergency room doctor's instructions regarding compression.
Step 5. Lift your foot
Make it so that it is above the level of the heart. Place it on a pillow or two to decrease blood flow to the area and consequently limit swelling.
Elevation allows gravity to eliminate edema and manage pain
Step 6. Take medication
To cope with physical pain and swelling, you can take NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuorifen (Brufen, Moment), naproxen (Aleve) or aspirin. Paracetamol (Tachipirina) is not an NSAID and does not act on inflammation, but it is a pain reliever.
- Take only the dosage recommended on the leaflet and in any case for a period not exceeding 10-15 days.
- Do not give aspirin to children under 18 years of age, as there is a risk of Reye's syndrome.
- If the pain is very severe and / or the sprain is second or third degree, your doctor may prescribe a sedative for the first 48 hours.
Step 7. Use a walking support or brace that immobilizes the ankle
Your doctor may suggest that you move with a device or splint the joint. eg:
- You may need crutches, a cane, or a walker, depending on your ability to maintain balance.
- Depending on the severity of the injury, your orthopedist may recommend that you use a bandage or brace to block the joint. In very severe cases, the surgeon may also cast the ankle.
Advice
- Immediately after the injury, the R. I. C. E. treatment begins immediately.
- If you can't get the affected foot down, go to the emergency room.
- If you are concerned that your ankle has been sprained, try not to place your foot on the ground as much as possible. Do not walk, but use crutches or a wheelchair. If you keep walking, your ankle has no way to rest and, in this situation, even a slight sprain will not resolve itself.
- Treat your ankle as soon as possible and apply ice packs for short periods several times a day.
Warnings
- If the limb becomes cold, the foot is completely numb, or is very stiff due to edema, then the problem could be much more serious. In this case, go to the hospital immediately, as you may need urgent nerve and artery surgery to resolve a compartment syndrome.
- It is critically important that the ankle heals completely after the sprain. If the joint does not recover properly, it will be more prone to other injuries. Eventually you may suffer from chronic pain and swelling.
