What does it mean when you sprain your ankle?
The word sprain is used pretty liberally in the common vocabulary. As one can now guess, an ankle sprain is a bit different from hurting one’s ankle. You are only suffering from an ankle sprain if you have torn ligaments in your ankle.
Ligaments are anatomical structures that connects bone to bone. There are a several different ligaments in the ankle, the two most important ones that usually get sprained are:
- Anterior talofibular ligament (ATFL): It is on the outside of the ankle and connects the talus with the fibula.
- Calcaneal fibular ligament (CFL): Connects the fibula with the calcaneus bone.
Ligament tears typically occur on the outer parts of the ankle and can be caused by a wide variety of activities. Although these ligament tears mostly happen on their own, people recovering from ankle fractures may have to endure sprains during the setting of the bones.
Ankle Sprain Grades
There are three major grades or degrees of ankle sprain. They are the following:
- First degree sprain: This happens when there is only a slight tear or stretching of the ankle ligament. In case of a first degree sprain, the joint is still functional. The anterior talofibular ligament is one of the most commonly involved ligaments in this type of sprain. There will be minor discomfort, such as a bit of pain, some amount of swelling and some localized stiffness.
- Second degree sprain: The tear is more severe compared to what occurs during a first degree sprain. The ankle joint becomes a bit unstable with some swelling that will be clearly visible to the naked eye. The affected person may endure serious pain if there is any weight put on the joint, such as during standing or walking without support.
- Third degree sprain: In a third degree sprain the ankle ligament is completely torn. The joint becomes completely unstable, hence walking or even standing without support will be impossible. There is severe pain at the time of tearing, which then goes away. The swelling will be even more prominent, compared to the second degree sprain.
Symptoms of an Ankle Sprain
Ankle sprains are extremely common, especially among athletes and they can be diagnosed very easily. The sufferer usually complains about pain after having “twisted” an ankle. One usually ends up twisting an ankle when one’s foot rolls under the ankle for whatever reason. In case of a sprain, the sufferer will notice the following:
- Mild to severe pain, especially if the sufferer tries to stand or walk.
- Various degrees of swelling, depending upon the severity of the sprain, as described earlier.
- There may be some bleeding under the skin, which would manifest itself in the form of a bruise.
How Long does a Sprained Ankle take to Heal?
Common sense suggests that the time it would take for an ankle sprain to heal would depend upon the severity of the tear. First degree sprains usually heal in anywhere between 5 to 14 days whereas second degree sprains may take between 4 to 6 weeks. A physician may put the ankle in a splint or an ankle boot to protect the area while it heals.
Third degree sprains are a lot more serious and some people may end up suffering from permanent instability in their ankles. Physicians typically put the sufferer in a short leg cast or walking boots for up to three weeks to immobilize the ankle during the healing process, which may last between 8 to 12 weeks. In extreme cases surgery may also be required.
Some people are born with weak ligaments, causing them to suffer from repeated sprains. In such cases surgery may be required to strengthen the ligaments.
Home Remedies to Treat Ankle Sprain
Provided the sufferer receives proper rest, a first or even a second degree ankle sprain will heal on its own. However there are several home remedies you can implement to expedite the healing process. Following are some of the most effective home remedies.
- P.R.I.C.E. therapy:
This easy to remember acronym can easily help you prevent causing further injury to the affected area and will let you recover completely from first and second degree ankle sprains. It consists of the following steps:
- Protect the area: One of the most common myths during a sprain is that one should immediately start massaging the area. Please do not do that! Not only does it not help, it may increase the severity of the injury. To prevent making the sprain worse, one needs to protect the afflicted ankle. This can be done by wearing sneakers, crocs or other footwear with a very soft sole and significant amount of padding on the sides.
- Rest: The first 48 to 72 hours after an ankle sprain is highly critical. To help expedite the healing one needs to avoid putting any pressure on the affected area. This means one needs to minimize walking or even standing as much as possible. Completely immobilizing oneself for three days may not be practical or even possible. Hence if the sufferer needs to get around, he should do so with the help of a wheelchair or crutches, or even a walking stick!
- Ice: Ice is a natural anti-inflammatory. The extreme cold constricts the blood vessels, increasing the blood pressure in the affected area and thus reducing the swelling in the process. Ideally an ice-pack should be applied on the affected foot for about 20 minutes every couple of hours for 48 to 72 hours after the sprain. Some may not be able to bear the extreme cold for 20 minutes straight. They should apply it for at least 10 minutes at a stretch, but they need to apply it every hour. If you do not have an ice pack, you can use a bag of frozen vegetables or you can wrap a few ice cubes in a washcloth and use that. Please make sure that the ice cubes are not in direct contact with your skin, as it may cause some lasting damage.
- Compression: Every pharmacy carry elastic compression wraps and your first aid kit is not complete without one. The wrap will not protect the area from injuries, however it will help distribute the weight in your ankles. The wrap should be comfortably placed and should never be too tight. If it is too tight, it may actually cause some additional damage to the area. Your compression wrap is a little too tight if you feel the following symptoms after putting it on:
- Increased swelling
- Tingling sensation
- Increased pain
- The tips of your toes turn blue.
- Elevation: Elevating the foot above the heart for about three hours every day for at least three days go a long way towards reducing the swelling and the bruising from an ankle sprain.
The anti-inflammatory properties of turmeric make it a natural painkiller. The medicinal properties of turmeric has been mentioned in Ayurveda (the ancient treatise of traditional Indian medicine) and it also extensively used in traditional Chinese medicine (TCM). Following are a couple of ideas that will allow you to use turmeric to eliminate the swelling from a sprained ankle:
- Add one teaspoon of turmeric to a glass of warm milk and drink it twice daily. If you are lactose intolerant then you can use soy milk or even water. You may also consider eating Indian food more often as most curries make liberal use of turmeric.
- Anecdotal evidence suggests that you can also create some external poultices using turmeric to help reduce the swelling. Some sources suggest that one needs to mix two tablespoons of turmeric, one tablespoon of lime juice with a bit of warm water. Other sources suggest that the lime juice needs to be replaced with limestone powder. Either way, even if the ingredients are ineffective, just the bandages by themselves can help with providing the compression, which as already stated, helps reduce the swelling.
- Epsom salt:
Crystals of magnesium sulfate, more popularly known as Epsom salt is highly effective in treating sprained ankles. This is because it relaxes the nerves on the affected area, thus acting as a topical analgesic.
To apply this treatment, simply pour a cup of Epsom salt in some lukewarm bath water and make sure that it dissolves completely. Simply immerse the sprained ankle and leave it in there for about thirty minutes. Feel free to apply this treatment twice daily for up to three days.
- Olive oil:
Olive oil contains several phenolic compounds that are renowned for its anti-inflammatory properties. There is a lot of anecdotal evidence that suggests that one can get some relief from an ankle sprain by mixing a tablespoon of olive oil in an egg yolk and applying it on the affected area and then covering it with a cotton pad. This poultice need to be protected with a compression bandage. The bandage should only be removed after two days and the treatment is to be re-applied if there is an improvement in the condition but the person is not fully healed.
Onion has strong anti-inflammatory properties that can be used to increase the efficacy of the compression treatment. Such properties are not only useful for treating ankle sprains, but can also provide relief from rheumatism, arthritis and jammed fingers.
Onions need to be applied with the help of the compression bandage mentioned in the P.R.I.C.E. treatment. Anecdotal evidence suggests that there are a couple of ways to do this:
- One can chop up a regular sized onion and apply it on the affected area and the compression bandage will hold it in place.
- It is also suggested that before the onion is applied, it should be refrigerated for a couple of hours. Then it should be mixed with salt before applied on the sprained ankle via the compression bandage. This is because salt is an astringent, which draw the juice from the onion and helps it seep into the sprained ankle.
Irrespective of the method used, the onion compression bandage should be changed every eight hours and should be applied for at least two days, or as long as the effects of the sprain are felt.
How to Wrap a Sprained Ankle?
Irrespective of which of the home remedies you decide to go with to treat a sprained ankle, you would’ve noticed that they are all applied via the compression bandage. This is because a compression bandage allows the ankle to stabilize, which is important for the healing process.
Before even applying the compression bandage, one needs to make a decision as to what kind of bandage one needs to use. The usual options are either an ACE bandage or medical tape. They both have their unique advantages.
Ace bandage: They are long bandages that stretch and needs to be held in place with the help of metal fasteners or adhesives. The main advantages of using an ace bandage are the following:
- As they are made of cloth, they are reusable. Simply wash and dry them after every use.
- As they stretch, they are incredibly comfortable as well!
- Athletes such as soccer players, sprinters, rugby players and American football players, among others use ace bandages to wrap their ankles before they gear-up. This is because ace bandages impede unnatural movement in the ankles, hence they go a long way towards preventing ankle sprains in the first place.
Athletic Tape: Athletic tapes are a useful alternative to ace bandages. They are mainly used for treating first degree sprain because they allow greater freedom of movement, while providing strategic support. The main disadvantage is that as these tapes are adhesives, they will pull on the skin and hair, hence changing the bandage will be cumbersome, if not a bit painful!
Making a compression wrap with an ACE bandage
You can easily prepare a compression wrap with the help of ACE bandages via the following steps:
- Start from the ball of the foot: This is always the starting point and the bandage should be placed in such a way so that it extends towards the outside of the foot, not inside.
- Wrap the top of the foot: While holding the end of the bandage from the ball of the foot, wrap the bandage around the top of the foot three times. There should be a gradual movement away from the heel, with an overlap over roughly half of the bandage. Extra care should be taken to ensure that there are no lumps or bulges. Lumps or bulges prevent the sprained ankle from receiving adequate support, besides being uncomfortable for the afflicted person. If this happens, it is recommended that the process be re-started.
- Hourglass wraps around the ankle: After you have wrapped the top of the foot about three times, then you need to wrap the bandage around the ankles. This is an extremely critical step of the process, because this step provides maximum support to the twisted ankle. However, one need not get too worried as this step is really easy to execute. After the three wraps on the top of the foot, just bring the bandage up on the outside of the foot, then take it over the instep and around the inside of the ankle. All in all, it should look like an hourglass or the figure eight. This needs to happen three times as well, with a 50% overlap, as done while wrapping the top of the foot.
- Hold it in place: Hold the end of the compression bandage in place with the help of metal fasteners or adhesive, depending upon what your bandage came with.
After you have applied the compression bandage, please remember to execute the following safeguards:
- As stated earlier, make sure that the compression bandage is not wrapped too tightly. If your foot goes numb, or if you feel a tingling sensation, you need to remove and then re-apply the compression bandage.
- Even if you did not make the bandage too tight, it will still impede blood circulation in the long run. To avoid that, remove the compression bandage every 12 hours to air out your ankle for about 30 minutes.
Making a compression wrap with an athletic tape
Creating a compression wrap with an athletic tape is just as easy! It can be done via the following steps:
- Shave the affected area: Athletic tapes have adhesives on them and if you have hair around your ankles, removing the tapes can prove to be an incredibly painful experience. Shaving the area can prevent a lot of pain later on.
- Use an underwrap: Even if you shave the affected area, the feeling of adhesive on skin isn’t a particularly palatable feeling. Hence it is highly recommended that you use an underwrap, which is available in most pharmacies and sporting goods stores, before you start wrapping your ankle with athletic tapes. Simply start at the ball of your foot and wrap it around and up to your ankles. Leave the heel uncovered.
- Anchor the underwrap: After you have wrapped your foot with the help of an underwrap, you need to ensure that it stay in place. To do so, tear off enough athletic tape so that it can wrap around your ankle 1.5 times. Use it to wrap it around your ankle in such a way so that the underwrap stays in place, which is why it called an anchor. After wrapping the anchor, make sure that the underwrap is secure. If you are not satisfied, feel free to repeat the process.
- Create a stirrup: Take a piece of tape and paste one end of it on the anchor. Now wrap the tape around the arch of your foot up the other side and paste the other end of the tape on the anchor. Repeat it with a few more tapes and ensure that there is some overlap. This is known as a stirrup and it helps hold the ankle in place.
- Create an “x”: Paste one end of the athletic tape on the ankle bone and run it diagonally over the top of the foot. Take it over the arch and continue running the tape towards the inside of the heel. Bring it over the heel and run the tape diagonally over the top of the foot to form an “x”.
- Create an “8”: The way this is done exactly the way you would create the hourglass shape using the ACE bandage, as described in the previous section. The only difference being that you will be using athletic tapes instead.
Rehabilitating Sprained Ankles
A sprained ankle can be rehabilitated with the help of the following steps:
Phase I: This involves rest, protecting the area and help reduce swelling with the help of the aforementioned steps.
Phase II: In this phase the ankle’s flexibility, range of motion and strength is slowly restored. This can be achieved with the help of the following exercises:
- Flexibility and motion exercise: Face the wall with one foot in front. Place your hands on the wall, bend the front leg and keep the back leg straight. Lean till the muscles are a bit stretched and hold the position for about ten seconds. Switch feet and repeat!
- Strength exercise: Take a rubber tube and tie one end to a stationary object and the other end on the forefoot. While being seated gently pull your foot against the tube while moving your knee as little as possible. Repeat the exercise with your other foot.
Please note that the Phase II exercises should only be started after you have allowed the ankle to heal adequately, depending upon the degree of the sprain.
Phase III: Slowly ease yourself into your regular everyday activities. However, please make sure that you do not strain or overtly exert your healing ankles!