Sprained ankles are a hazard for anyone, particularly with the weather as icy as it is at present. They can be extremely painful, to the extent that the casualty is unable to put weight on the affected leg and the joint can swell rapidly, preventing them from getting into their footwear. In severe cases the ligament can tear bone away at the point where it attaches (an “avulsion fracture”) or the ligament can tear completely, resulting in chronic instability of the ankle and the potential for long term damage.
Most ankle sprains, however, are relatively mild and do only temporary damage to the ligaments joining the fibula (the bone on the outside of the lower leg) to the bones of the foot. If you are in any doubt, have the injury checked by a professional to rule out fractures or other serious damage.
The important thing is to ensure that no further damage occurs after the sprain and that the repair to the ligaments is as thorough as possible. Oh, and relieving pain is a good idea too.
The traditional remedy is RICE: Rest, Ice, Compression and Elevation.
Rest – this doesn’t mean sit in bed eating crisps. It just means don’t do anything to aggravate the injury. It might mean having to avoid walking, or having to use a crutch in order to offload the injury. But that doesn’t mean that other forms of exercise can’t be carried out – swimming, perhaps, as long as it’s relatively pain free. And it has been shown that standing on the uninjured leg will improve the feedback to the brain from both sides (“proprioception” for those who like fancy words).
Ice – for the first 24 hours, apply ice to the sore area (generally over the ankle bone, but also over the top and side of the foot) for 5 minutes at a time every couple of hours. This will help stop the bleeding which occurs around the injured tissue, and which leads to all that bruising around the ankle and in the bottom of the foot. After the first day, increase the time spent icing to 15 minutes. If you can do this every couple of hours, fantastic. Most people with normal lives can manage 3 or 4 times a day. Use frozen peas if you don’t have a proper ice-pack, but remember to wrap them in a damp cloth first – ice on bare skin can cause a cold burn injury. The reason you have increased the time is because the damage to the blood vessels will now have healed and the added time under ice will cause them to expand, allowing more of the inflammatory chemicals to get at the injury. These are necessary – inflammation is what heals wounds.
Compression – wrap the injury reasonably firmly in a stretchy bandage or Tubigrip. This will help to flush out the inflammation and get rid of the swelling.
Elevation – just what it says. Put your foot up. Again, this helps to drain the injured area, thus reducing swelling.
As soon as possible, start moving the ankle – rock the foot up and down, tip it from side to side, wiggle it round in circles.
At least 3 times a day, practise standing on just the good leg. Start with your eyes open and see if you can get to a minute without falling over, then progress to doing it with your eyes closed.
Once the pain has subsided, start doing gentle exercise (walking, possibly with a crutch for support). When pain permits, start doing the one-legged standing exercise on the injured leg.
Drugs Many people turn immediately to Ibuprofen. This is primarily an anti-inflammatory drug, so actually reduces the body’s healing processes (remember: inflammation is necessary). It also has the potential to cause some nasty side-effects, as do almost all the NSAIDs (non-steroidal anti-inflammatories). Paracetemol is a better pain-killer – but do keep within the the recommended dose. Ice will also help to relieve the pain.
Healing An ankle sprain may take 2 months to heal and you have to be careful not to return to exercise or sport too soon. Remember that the sprain won’t have healed properly until long after the pain has gone and it is not unusual for problems to remain for as much as 10 months. Overuse will increase the amount of scar tissue present, permanently weakening the ligaments and making the same injury more likely in the future.
Speeding Things Up For serious sportsmen and women, there are quicker ways to resolve the injury, but these need professional care and specialist equipment such as ultrasound. Our experts at The Ashgrove Clinic can help in this regard – contact us on 01933 469043 or through by email: info@ashgrovehealth.co.uk
Many of the people we see at The Ashgrove Clinic are suffering from neck pain. And most of them come to us because they are unhappy that they have been prescribed anti-inflammatories by their GP – either they don’t like taking drugs, they feel that drugs simply mask the underlying problem, or they find that the drugs are simply ineffective.
Anaphylaxis is a severe, allergic reaction. Because it can cause swelling of the airway, it is possible that the casualty may become unable to breathe. The heart and blood pressure are also affected and if they are not treated very quickly, they may die.
A blotchy, red nettle rash which could be anywhere on the body
If a casualty is aware that they suffer from anaphylaxis, they should be carrying adrenaline in an “auto-injector” pen. In these, the drug is contained in a plastic “pen”; when activated, a spring forces the needle through clothing into the skin and the adrenaline is forced into the muscle below. There are two common types of auto-injector: Epipens and Anapens. These are shown in the image to the left. If the casualty cannot get to their medication themself, fetch it for them immediately if it is nearby. If it is not, or if they do not have an auto-injector 
Rushden girl Jo Redman, sponsored by The Ashgrove Clinic, won the world title at the WKC Kickboxing World Championships in Cadiz, Spain in November. She beat contenders from around the world, including Canada, Germany and the reigning world champion from Ireland to become the Women’s World 70Kg Light Contact Champion.