Common Ankle Injuries & How to Treat Them

Every day, 25,000 people in the United States sprain their ankles. Additionally, more than 1 million people annually visit the emergency room due to an ankle injury. 

Your ankles are some of your body’s most important weight-bearing joints. A majority of your lower body’s movement relies on the health and stability of your ankles. Yet, this also makes them prone to injury as seen by the statistics above. 

The most common ankle injuries include strains, sprains, and fractures. We want to share more information about each type of injury including the causes, symptoms, and treatments.

Common Ankle Injuries

Before we dive into ankle injuries, let’s have a quick anatomy lesson. This will help you understand more about how injuries can occur in the ankle.

ANATOMY OF AN ANKLE

You have three major bones that make up the structure of your ankle: fibula, tibia, and talus. The tibia is the shin bone. The fibula is the thinner bone of the lower leg that runs next to the tibia. The talus is a small bone that sits between the heel bone and the tibia/fibula. 

In addition to these bones, your ankle has muscles, ligaments, and tendons. Muscles are tissue that contract and relax which causes movement in the joint. Ligaments are tissue that attaches bone to bone. Tendons are tissue that connects muscle to bone. These help hold everything together and give your ankle the ability to move.

All of these components work together to provide your ankle joint with stability. When you damage any part of your ankle, it can end in injury. 

Here are some of the activities that can cause ankle injuries:

• Accident (bike or car)
• Dropping a heavy object
• Exercising
• Falling
• Hiking
• Running
• Slipping on ice or snow
• Sports activities
• Standing or sitting in an unnatural position
• Tripping
• Walking
• Wearing high heels or ill-fitting shoes

Now let’s look closer at the different types of injuries, including how you can identify and treat them.

STRAINED ANKLE

A strained ankle is the least severe of the ankle injuries. It occurs when muscles or tendons in the ankle are injured. This can happen when they are pulled, stretched, or twisted beyond their normal ability. Ankle strains can be minor to severe. They become severe when the muscle or tendon is torn. 

An acute ankle strain happens suddenly. An example of this might be that you twist your ankle while walking. A chronic ankle strain happens over several days or weeks. One example is the overuse of your muscles during physical activity, preventing enough rest between sessions. 

SYMPTOMS

You will find that many of the symptoms are shared among the three types of ankle injuries. However, there are some subtle differences. 

Here are the symptoms that you might experience with a strained ankle:

• Muscle cramps
• Muscle spasms
• Muscle weakness
• Pain
• Restricted range of motion
• Swelling

TREATMENTS

RICE Method

As soon as you identify that you might have injured your ankle, we recommend that you begin using the RICE method at home immediately. Implementing this over the first 48 hours can help speed up your healing as well as help you determine if something more serious is happening.

Here is the RICE method:

1. Rest - Pain in your ankle is the first sign of a problem. Take time to rest. Avoid standing and walking if possible. Limit your physical activity over the next 24 to 48 hours. Pushing through the pain may exacerbate the injury. 
2. Ice - Using ice helps reduce pain and swelling. For the first 24 to 48 hours, put ice on the injured area for 20 minutes, then remove it for 20 minutes. Repeat often during the first few hours then continue to use ice every couple of hours. Remember to use a thin towel or bandage wrap to protect the skin. If you do not have an ice pack, use a frozen bag of veggies.
3. Compression - Wrapping the injured area helps prevent swelling. Use an elastic bandage to wrap the ankle snuggly. Do not wrap it too tightly as it can compromise the blood flow to the area.
4. Elevate - Keeping the injured ankle elevated can help reduce the pain and swelling. If possible, lift your ankle above the level of your heart. Lay on your bed or couch and use pillows to prop your ankle up. If you need to sit up, try to keep your ankle elevated at least above your waist level.

Over-the-Counter (OTC) Medications 

To help manage your pain, you may want to use the following over-the-counter medications:

• Nonsteroidal anti-inflammatory medications (NSAID) - Examples of NSAIDs include aspirin (Bayer), ibuprofen (Advil or Motrin), or naproxen (Aleve). These help to decrease pain and swelling.
• Acetaminophen - The most well-known brand of acetaminophen is Tylenol. This can help decrease pain.

As with all medication, always read and follow the directions on the label. If you have any concerns about taking OTCs based on current medical conditions or medications, seek the advice of your physician before taking them.

SPRAINED ANKLE

A sprained ankle is when the ligaments of the ankle are injured. This occurs when they are stretched or twisted beyond their normal range of motion. 

Spraining your ankle can be minor when the ligament is overstretched. The sprain increases in severity if a ligament tears. Tears can range from a micro-tear to a partial tear (sprain) to a full tear (rupture). 

SYMPTOMS

Here are the symptoms that you might experience with a sprained ankle:

• Bruising
• Difficult to put weight on the joint
• Heat and redness at the injury site
• Instability
• Pain
• Popping feeling or sound when the injury occurs
• Restricted range of motion
• Swelling
• Tenderness when you touch it

You will notice some of the same symptoms on this list as the strained ankle list. One of the big differences between a strain and a sprain involves muscles and bruising. With a strain, muscle cramps, spasms, and weakness is common since the injury involves the muscles. With a sprain, you will see bruising.

TREATMENTS

RICE Method and OTCs

Like with a strained ankle, the treatment for a sprained one is identical for the first 24 to 48 hours. 

• Apply the RICE method. 
• Take OTCs to help minimize the pain and swelling.

Other Treatment Options

If you do not see improvements after 48 hours, schedule a visit with a medical professional. The injury may be more severe and require additional treatment options.

Here are other treatment options you may need depending on the severity of the strain:

• Mobility aid device - Using crutches helps keep your weight off the ankle until it heals. Using a brace helps provide stability. These are just two examples.
• Physical therapy - Working with a physical therapist can help strengthen the injured joint and improve its movement. 
• Surgery - This may be an option for a severe sprain where the ligament is torn. We’ll share more information about when to consider surgery further in the article.

FRACTURED ANKLE

A fractured ankle is the most complex of ankle injuries. It occurs when one or more of the ankle bones breaks. 

There are three types of fractures in ankles:

• Nondisplaced - The bone is cracked or broken. However, it retains its proper alignment.
• Displaced -  The break has caused bone fragments that have come out of alignment. There may be breaks in several places or the ankle might be dislocated.
• Open - Also known as a compound fracture, this is when the bone breaks through the skin. If this happens, seek immediate medical attention. Due to the open wound, there is an increased risk of infection.

SYMPTOMS

Here are the symptoms that you might experience with a fractured ankle:

• Bruising
• Looks deformed
• Numbness and coolness in the foot
• Pain that is immediate and severe
• Swelling
• Tenderness to the touch
• Unable to put any weight on it

Initially, the symptoms may imitate a sprained ankle. If they do not dissipate or improve after the first 24 to 48 or if they worsen, visit your doctor. They will be able to examine your ankle and run tests to determine if there is a fracture.

TREATMENTS

Treatment options depend on the severity of the break.

Nondisplaced Fracture

Surgery is usually not required. Instead, you can use the RICE method. You may be given a short leg cast, brace, or walking boot. This will help stabilize the break while it heals. 

You will also need to limit movement for several weeks depending on the location of the break.

Displaced or Open Fracture 

To realign the bone fragments, surgery typically is required. The surgeon will use screws and plates to securely place the bones back into alignment. A cast will help stabilize the ankle while it heals.   

Most ankle fractures take at least six weeks to heal. If the break is severe, it may take several months. Additional healing time may be needed if ligaments and tendons were injured.

Pain Management

If surgery is required, your doctor may provide you with a prescription for pain medication to use as needed. Follow the instructions provided.

If you need additional pain medication or did not get a prescription, you can use over-the-counter medication to help manage your pain.

Rehabilitation

Remember that it takes time to heal. The more severe the fracture, the more time is needed. Take it slowly as you resume your normal activity to ensure that you don’t cause more damage.

Your doctor may advise that physical therapy is needed. This will help you rebuild strength in the ankle (bones, muscles, ligaments, and tendons). The physical therapist will provide you with exercises that will aid in your healing. 

Why is it Dangerous to Let an Ankle Injury Go Untreated?

As mentioned previously, your ankle is an important weight-bearing joint. If injured and the injury goes untreated, you risk major and permanent damage. 

The great thing is that most minor ankle injuries can be healed at home using the RICE method, crutches, and lots of rest. However, if you do not see improvements in a couple of days or symptoms worsen, seek medical attention from a trained professional who specializes in ankles.

If an ankle injury is left untreated, here are some of the possible outcomes:

• Arthritis
• Chronic inflammation
• Chronically unstable ankle
• Feeling like your ankle may give out at any moment
• Foot deformities
• Impacted ability to stand and walk
• Impaired walking
• Increased chance of experiencing degenerative changes
• Increased risk of more injuries in the future
• Increased risk of infection

When Does an Ankle Injury Need Surgical Intervention?

As we’ve mentioned, most ankle injuries do not require surgery. If your injury is severe or becomes chronic, your doctor may recommend surgery to help you make a full recovery. 

Surgery might be needed for the following reasons:

• To repair a torn ligament
• To attach and realign a fractured bone

How Can I Prevent Ankle Injuries?

To help you prevent ankle injuries, here are several tips:

• Avoid tripping and falling hazards
• Be cautious in bad weather conditions
• Start a new exercise plan slowly then increase the distance, time, and intensity
• Strength train
• Take breaks as needed when walking, running, exercising, and playing sports
• Warm up before and cool down after physical activities
• Wear proper shoes when playing sports or exercising and use any equipment properly

If you live in the Idaho Falls area and have experienced an ankle injury, call Teton Foot & Ankle Center to schedule an appointment today. Dr. Michael James, a double board-certified podiatrist and his highly-qualified team, take great pride in providing their patients with the best podiatry care possible.