Thursday, November 21, 2013

Ankle Sprains - Dr Bruce E Ellison MD – Offices Near Sequoia Hospital & El Camino Hospital

A sprained ankle is a very common injury.  Approximately 25,000 people experience ankle sprains daily.  A sprained ankle can occur with athletes and non-athletes, children and adults.  Ankle sprains may occur when participating in sports and physical fitness activities, or simply stepping on an uneven surface, or step down at an angle.
The ligaments of the ankle hold the ankle bones and joint in position.  These ligaments protect the ankle joint from abnormal movements-especially twisting, turning, and rolling of the foot.  The ligaments usually stretch within their limits, and then go back to their normal positions.  If there is a severe in-turning or out-turning of the foot relative to the ankle, the forces cause the ligaments to stretch beyond their normal length.  When a ligament is forced to stretch beyond its normal range, a sprain occurs.  A severe sprain causes actual tearing of the ligament elastic fibers.  When excessive force is applied to the ankle’s soft tissue structures, an audible “pop” may be heard with resulting pain and swelling.
The amount of force determines the grade of the sprain.  A mild sprain is a Grade I injury with slight stretching and some damage to the fibers (fibrils) of the ligament.  A grade II injury involves tearing of the ligament. If the ankle joint is examined and moved in certain ways, abnormal laxity of the ankle joint occurs.  In a grade III ankle sprain injury, complete tears of the ligament occur.  If the examiner pulls or pushes on the ankle joint in certain movements, gross instability typically occurs.  MRI may be used to confirm the diagnosis severe injury to the ligaments, and is typically used to diagnosis injury to the ankle joint surface, possible occult fracture of the ankle, or a small bone chip among other problem.
Most ankle sprains need only a period of protection to heal over approximately four weeks to six weeks.  Even complete ligament tears typically heal without surgical repair if the ankle is immobilized appropriately.  Even if an ankle has a chronic tear, it can still be highly functional because overlying tendons help with stability and motion.  Ambulation may be difficult because of the swelling and pain, and crutches may be required if walking causes pain.  Depending upon the grade of injury, the patient may be placed in a cast, removable plastic castboots or air splints.