Ankle Sprains: A Minor Concern with Potential Consequences for Ankle Arthritis

A sprained ankle may appear as a commonplace injury that can happen to just about anyone. Frequently, individuals regard it as a minor concern, often resulting in a lack of proper initial care or the incorrect treatment of the sprained ankle. Nevertheless, it is crucial to recognize that the degree of an injury resulting from an ankle sprain can vary from mild to severe. Hence, it is essential to administer appropriate treatment for a sprained ankle, as neglecting it can potentially escalate into a more significant issue, such as ankle arthritis.

Effects of an ankle sprain

Ankle sprains typically result from accidents and are frequently observed in athletes engaged in sports that demand extensive ankle mobility and involve physical contact, such as football or basketball. Furthermore, individuals with preexisting ankle instability are particularly susceptible to experiencing ankle sprains. Sprained ankles can be categorized into three levels of seriousness, as outlined below:

• Mild: Characterized by mild inflammation in the ligament, accompanied by slight swelling but no tearing. Patients can typically continue walking.
• Moderate: Involves partial ligament tear, leading to increased pain, difficulty walking, and challenges with weight-bearing.
• Severe: Represents a complete ligament rupture, resulting in the inability to bear weight, move, or walk.

The seriousness of an ankle sprain is contingent upon the extent of the injury and the nature of the accident. To illustrate, a minor ankle sprain accompanied by minimal pain would be categorized as a mild sprain. Conversely, a moderate ankle sprain may cause more pain. A severe sprain, on the other hand, typically results from a complete tear of the ligament and is often associated with high-impact accidents, such as falling down a flight of stairs or motorcycle accidents.

Apply ice, but not heat

One common mistake people make when dealing with ankle sprains is using a warm compress as their initial first aid approach. When an injury occurs, the ligament may become stretched, leading to inflammation, bleeding, and swelling. Consequently, it is essential to apply a cold compress to reduce this inflammation and swelling. Applying a warm compress as the initial treatment can increase blood flow, exacerbating the swelling and pain.

Another typical error is wrapping a sprained ankle too tightly, which can further aggravate the swelling. The correct method to immobilize a sprained ankle is to wrap it neither too tightly nor too loosely. The recommended protocol for managing an ankle injury is the P.R.I.C.E. protocol:

• P = Protection: Safeguard yourself from further harm by discontinuing the activity or movement that caused the injury.
• R = Rest: Allow the injured area to rest and avoid putting weight on it.
• I = Ice: Apply ice to the injured area for 10-15 minutes every 6 hours to minimize inflammation and relieve pain.
• C = Compression: Use it to restrict excessive movement in the injured area, which can help reduce swelling.
• E = Elevation: Elevate the injured foot to a higher position to reduce swelling.

Could an ankle sprain be worse than what it may seem?

In addition to severe injury, including complete ligament tears and fractures, an ankle sprain can damage the cartilage in the ankle or tears in the cartilage. When the cartilage becomes damaged, it can lead to the wearing down of this crucial component.

Signs and symptoms indicative of a severe ankle sprain include:

• The presence of a popping sound during the injury
• The injury substantially impacts everyday activities 
• The inability of the ankle or foot to bear weight
• Severe pain and significant swelling.

These symptoms may suggest the involvement of numerous torn ligaments. If such symptoms manifest, it is advisable to seek medical evaluation. A healthcare professional may recommend applying a soft splint for two weeks. In cases where the condition does not show improvement, further assessments, such as with an MRI, may be necessary to determine whether areas beyond the initial injury site have also sustained damage.

In instances of damaged cartilage, it may warrant surgical intervention. The decision to proceed with surgery depends on the extent of the damage and the assessment of a specialist.

Untreated ankle sprain can be even more detrimental

The primary factor that can turn common ankle sprains into more severe conditions is the absence of proper treatment or neglect of the injury. When a sprained ankle does not receive appropriate treatment and is correctly immobilized, or when the patient does not undergo necessary physical therapy, it can lead to ankle instability from the ligaments healing in a lax state.

In simple terms, it takes approximately 4-6 weeks for damaged ligaments to heal, depending on the severity of the injury. However, during the initial stages of the injury, Improper immobilization and positioning of a sprained ankle during the initial stages of the injury, as well as constant movement, can compromise the healing process of the ligaments. The stretched ligaments lead to ankle instability. Repeated ankle sprains and ongoing damage or inflammation can lead to the formation of scar tissue in the 0ankle.

Furthermore, untreated damaged cartilage can trigger inflammation. Gradual cartilage wear, swelling, and chronic ankle instability may cause an ankle deformity and chronic arthritis.

How can a doctor help with a severe ankle sprain?

In the event of an ankle sprain or injury, you should consult a specialist initially to assess the severity of the condition. Depending on the assessment, the specialist may prescribe a cast, soft splint, or a walking boot. Once the inflammation subsides, patients can start physical therapy to strengthen the ligaments and sensory nerves in the injured ankle, ultimately aiding in the return to a normal state.

Individuals with severe ankle sprains or ankle instability should promptly seek medical attention. In contemporary ankle sprain treatment, ankle arthroscopy is a viable option. This procedure involves a small incision made by the doctor to insert a tool that tightens stretched ligaments. Additionally, ankle arthroscopy allows for the removal of scar tissue in a single session.

Ankle arthroscopy is also suitable for the repair of damaged cartilage.
For cases involving ankle deformity, a doctor may perform surgery to correct the alignment of the foot bones.

To avoid potential surgery, it is imperative to strictly adhere to the doctors' instructions regarding the care of an ankle sprain.