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UPMC Specialist: Understanding Ankle Injuries: Strains, Sprains, and Breaks

Though a very common injury for athletes, ankle injuries can happen to anyone at any time. Hiking down your favorite local trail, walking down the stairs with a loaded laundry basket, or mowing the grass in the backyard and stepping into that ditch you’ve been meaning to fill in — it can happen to anyone. Ankle injuries come in different severities. Sometimes a couple days on the couch of resting and icing can do the trick but other times a trip to the doctor is needed to differentiate between a sprained or a broken ankle.

What’s a sprained ankle?

An ankle sprain occurs when the ligaments that surround the ankle joint become injured. A sprain happens when the ankle rolls, turns or twists beyond its normal motion and is more severe if the ligaments are torn rather than stretched. Significant bruising around the joint and into the foot may be a sign of torn ligaments. Many sprained ankles are recurring ankle sprains that never completely healed. It’s important to make sure you’re fully healed before returning to physical activity and that starts by using the R.I.C.E. treatment:

Rest the injured ankle (using crutches or walking boot if needed),

Ice for 10 to 20 minutes with a half-hour break in between treatments,

Compress the injury by wrapping the ankle in a bandage and

Elevate the foot at least 30 degrees above heart level when possible.

It’s important to start R.I.C.E. as soon as possible after injury to quickly get back on your feet. Recovery time depends on the severity of the injury, most sprains require two to six weeks to heal. Overall, treatment of a sprain involves three steps: control inflammation, regain strength and range of motion.

You should also see your physician to rule out a broken ankle, especially if the injury is unusually painful. Constant aching, night pain and inability to bear weight on your ankle for four steps can be a sign of a fracture. Since the most important risk factor for ankle sprains is a previous sprain, you may decide to see a physician to lower the risk for recurring problems.
What’s a broken ankle?

A fractured or broken ankle is a partial or complete break of one or more bones in the ankle. People most commonly break an ankle when doing physical activities like running and jumping, however, any impact from falling or tripping also can cause a fracture. Traumatic events such as car accidents are another common cause of fractured or broken bones. Although the severity may vary, broken ankle injuries are highly treatable for most people.

Symptoms of a broken ankle are similar to a sprained ankle and can include, but aren’t limited to, swelling, bruising, and, in some cases, visible deformity and difficulty bearing weight. Though sprained ankles can sometimes be diagnosed at home, broken ankles need to be examined by a doctor and sometimes x-rays and MRIs are needed.

Common types of broken ankles include stable and unstable fractures. A stable fracture is one in which the broken bones remain aligned with each other and are barely out of place. An unstable fracture occurs when there are multiple breaks, the break extends into the ankle joint or there is damage to the cartilage. Unstable ankle fractures are most common in athletes who play high-impact running sports such as football, basketball and soccer. Stable fractures can usually be treated with a boot or cast while unstable breaks typically require surgery to reset ankle bones and ligaments. Recovery times also vary, some are back on their feet in as little as two months with restrictions on strenuous activity but injuries that require surgery can take up to a year before fully recovered.
Preventing ankle injuries

Accidents are going to happen and, in turn, so are injuries. But there are ways we can help prevent ankle injuries. Stretching and exercise can go a long way in decreasing the chance for ankle problems, but it’s important not to overdo it. Equipment is also very important, making sure you have shoes with good support that are high enough to provide stability. Reinjured ankles are very common. An ankle brace or compression sleeve can decrease the chances and help you keep you on your feet and off the couch.
Zachary Ritter, DPM, is foot and ankle specialist with UPMC Foot & Ankle services. Dr. Ritter sees patients at UPMC Specialty Care, 2330 Saint Mary St. West, Floor 1, Lewisburg, and UPMC Foot & Ankle, 1201 Grampian Blvd., Suite 2F, Williamsport. To schedule an appointment with Dr. Ritter, call 570-321-2020. For more information, visit UPMC.com/FootandAnkleNCPA.

Understanding Ankle Injuries:
Strains, Sprains, and Breaks
Zachary Ritter, DPM
Podiatry, UPMC Foot & Ankle