How to Self-Treat an Ankle Sprain

As people get more active at this time of year, it is inevitable that risk of ankle sprains will rise. Ankle sprains are an injury that people often to treat themselves without the guidance of a doctor or therapist. The typical approach people take to recover from an ankle sprain is to restrict movement of the ankle, ice it, take anti-inflammatory medication and allow time to heal the ankle on its own. This approach however, does not guarantee that the ankle will heal properly. It is important to know what to do in the event that you sprain your ankle to guide proper healing as the consequences of poor healing include chronic stiffness, pain, and recurrent ankle sprains.

Ankle sprains occur when the person suddenly rolls over on the outside of the ankle and the ligaments that provide support to the ankle are stretched beyond their natural range. Tearing of the ligament fibres occur which immediately signals the inflammatory system to begin the job of healing the damaged area. The result of inflammation is the swelling, redness, heat and pain that is associated with a sprained ankle. Inflammation is of course, necessary for the healing process to occur. Your body will heal itself, but how you treat yourself will affect the quality of the healing process and will affect the future health of your ankle.

Provided below is a step by step approach of what you should do to treat an ankle sprain. Consult your trusted practitioner (family doctor, chiropractor, physiotherapist) for guidance on how to manage any injury properly if symptoms do not subside within a couple days or if you suspect severe damage has been done.

The first phase of treatment is to minimize soft tissue swelling and manage pain -72 hours

In the first 72 hours after an ankle sprain, the main objective is to minimize soft tissue swelling and manage pain associated with inflammation and regain some range of motion.
1) Apply a covered ice pack to the injured area for 20 minutes. Ice should be applied every 2 hours during hours that you are awake for the first two days. Ice will help control internal bleeding and minimize tissue swelling.
2) Apply a compression wrap over the ice.
3) Elevate the ankle.
4) When the foot is elevated with ice, passive range of motion exercises can be performed. To do this, place a strap around the ball of the foot and gentle pull the foot towards your body. Move the foot forward and back using the strap to guide the movement.
5) It is important to use crutches when walking to keep weight off the ankle. Some drug stores will rent crutches out to the public.
6) On the third day, introduce active range of motion by moving the foot towards and away from your body without the strap.
7) On the third day trace the alphabet with the big toe. Gentle movements of the foot helps promote proper healing of the ankle ligaments so that range of motion is not compromised.

The second phase of treatment is to improve range of motion and re-strengthen the ankle- to be done after pain and swelling subsides.

1) Heel cord stretching: Stand on the edge of a step on the balls of your feet. Lower your heels off the step to allow for a gentle stretch of the heel cord. Hold stretch for 30 seconds. Repeat 3 times.
2) Toe raises: Stand on the edge of a step on the balls of your feet. Raise on toes and hold for 3 seconds. Slowly lower the heel for a mild stretch and raise up on your toes again for 3 seconds. Repeat 10 times.

The third phase of treatment to improve ankle stability and return to activity- to be done when the ankle tolerates weight

1) Once your ankle tolerates weight bearing, practice standing on the injured foot to improve balance. The ultimate goal is to be able to balance for 20 seconds.
2) Stand on the injured foot and lift the heel off the ground then slowly lower it. Repeat ten times for three sets.
3) Once you are able to put your full weight on the ankle normally with no pain, you are encouraged to gradually begin increasing your activity.
4) If you are a runner begin running for short distances on a flat surface. You may have to ice the ankle after the first attempts at running. Once you are able to run for 20 minutes, you may return to usual activity.

Provided are detailed guidelines for what to do to promote proper healing of an ankle sprain. It is important to self manage ankle sprains properly to prevent future problems with the ankle. The next article will discuss what to do if you suffer from recurrent ankle sprain.

Three Reasons Why Crocs May Be Good For Your Feet

You either love them or hate them, but it appears that the infamous foam clog is here to stay. Patients are constantly asking me if Crocs are a good or bad choice of footwear. My general opinion of Crocs is that they are a reasonably good shoe. Since it appears that Crocs have outlived the fad, I’ve done some homework for you to support my opinion. Coordinating them with your outfit is truly up to you! There is no question that what you wear on your feet is extremely important. Your feet are your foundation for walking and standing. If your foundation is not good, you will likely develop problems in the feet, knees, hips or low back. How long it takes for problems to develop depends on how well your body compensates for mechanical strain. I have provided three reasons why Crocs may be good (orthopedically speaking) for your feet. 1) Stability is Good Crocs provide a wide base of support which in turn provides good stability to the foot. Stability is important for balance and may help prevent rolling over on the ankles. 2) Good Cushioning Support Crocs do a good job of distributing pressure throughout the foot. The foot provides shock absorption for the entire body with each step that you take. Many people have structural foot problems (and don’t realize it) that result in poor shock absorption. Poor shock absorption causes strain to accumulate in the joints and soft tissues of the feet, knees, hips or spine which can result in various injuries. High pressures on a diabetic’s foot can cause ulceration to occur which can have disastrous consequences if the person fails to notice due to loss of sensation. A shoe with good cushioning support can help to distribute pressure throughout the foot. 3) Medial Arch Support and Small Heel Crocs have a decent medial arch support and a slightly lifted heel which helps prevent excessive collapse of the arch. Excessive collapse of the arch, known as over-pronation is extremely common and the main reason people are prescribed orthotics. Over-pronation is seen in people of all ages from children to the elderly. Keeping the arch supported helps minimize physical strain on the body. It is not known whether wearing Crocs will prevent mechanical problems or injuries from developing. I would not recommend them in place of orthotics or orthopaedic shoes but they have certainly earned their place on my list of “good” shoes.