Every fifth person in the world experiences sprained ankles, the statistics are disappointing. Among women, those representatives of the fair sex who prefer high and unstable heels fall into the risk group. As for men, powerlifters, runners, and those who are professional basketball or football players are most at risk of injury.
What could be causing it?
The main cause of ankle sprains is wearing shoes with a high platform or heels. As a result of walking in shoes with heels, the load on the ankle is unevenly distributed, which in turn ends in injury to the ligaments.
Many athletes are not immune to this kind of sprain, when a joint is subjected to heavy stress without prior preparation. Ligaments are partially torn, thereby saving the bone from further damage.
Besidesof this, any injury can cause an ankle sprain:
- Jumping or falling from a height.
- Kick on the foot.
- Deformation of the leg due to too much load (icy, uneven mountain surface).
At the same time, any he althy person's ligaments are strong and not easily stretched. However, if they are weakened, then in this case stretching cannot be avoided. What can loosen ligaments:
- Constant load on the ankle joint from an early age.
- Overweight.
- Flat feet present from birth or connective tissue disorder.
- Lower limbs vary in length.
In addition, the ligaments are affected by instability of the ankle joint, which appears due to arthrosis, osteomyelitis and other internal inflammatory processes.
Signs of an ankle sprain
When the ankle is sprained, a person immediately feels pain. In some cases, you can hear a crunch, and even a pop.
The characteristics are as follows:
- tissue swelling;
- appearance of a hematoma;
- burning sensation on palpation;
- the appearance of acute pain sensations of a pulsating nature (when stepping on the foot, turning the joint to the sides and even at rest);
- the temperature rises where the stretch occurred.
Typically, this symptomatology is also characteristic of bone fractures.
Degrees of stretchingbundles
Because ligaments do not have nerve endings, pain, even with severe damage, can manifest itself in different ways. In total, there are three degrees of severity of sprain. Accordingly, the symptoms of a sprained ankle listed above may be mild or severe.
I degree
In this case, ankle sprain often occurs with a slight dislocation or a fall. The integrity of the ligaments is still intact, with the exception of a number of fibers that are partially torn.
Sprain can be cured at home. Damaged tissues are able to recover quickly. In this case, most of the load falls on whole ligaments. The victim does not need assistance and can move independently.
II degree
Occurs as a result of a strong fall or impact. The damage is more extensive - most of the fibers that form the ligaments are affected. However, the integrity is also not yet broken, and therefore conservative treatment will give the desired results. Therefore, there is no reason for panic in women who have sprained their leg. However, you should not refuse to consult a doctor either.
In pain, it seems that the bones of the ankle or foot are broken. It is already difficult for a person to lean on his leg, often he needs outside help when moving. In this case, in order for the recovery process to begin, the limb must be at rest. Otherwise, when walking, soft tissues can seriouslyget hurt.
III degree
Here we are already talking about a complete rupture of the ligaments, which usually happens with a serious dislocation of the ankle joint or a fall from a great height. As a rule, such an injury accompanies a broken bone.
In this case, it is almost impossible to do without surgery. Under normal conditions, the ligaments are constantly slightly taut, and as a result of a rupture, they are completely separated.
It is necessary to restore their integrity by fixing the fibers with suture material. If sprain occurs against the background of rupture of muscle fibers or tendons, a bone fracture, it is necessary to apply a plaster cast. This happens to many athletes. They can twist their leg almost every day.
Diagnosis
To make an accurate diagnosis, the doctor needs to understand the bone is a fracture or sprain. To do this, first of all, a simple palpation procedure is carried out and, of course, a visual inspection.
After that, the doctor may prescribe a number of additional studies:
- X-ray. This is the most informative technique for determining bone fractures.
- Contrast arthrography (X-ray examination using contrast fluid). The contrast agent is injected into the joint, penetrating into the area of attachment of the ligaments. And if there is a gap, it will be detected.
- Ultrasound - the procedure allows you to examine the soft tissue and bone structure using ultrasound.
- MRI is a giventhe study is carried out with complex injuries of the ankle joint and allows you to determine the need and method of surgical intervention.
At home, it is not possible to perform an accurate diagnosis for an ankle sprain. Recovery time is also unlikely to be set on your own, so you should definitely consult a doctor. Often, a simple visual inspection is sufficient to detect a Grade I or II sprain.
In order to distinguish partial damage to the fibers from their complete rupture, it is enough to pay attention to the structure of the ankle. Its anatomically correct shape indicates that the integrity of the ligaments is preserved.
Controversies
In some cases, controversial situations may arise during the diagnosis, and then stress testing comes to the rescue. The patient needs to take a supine position on his back, bending his knees. The doctor holds the lower leg with one hand, and begins to move the heel forward with the other.
The appearance of pain when moving the limb back and forth or in different directions will be a clear indication of a strong sprain.
First aid
In order not to aggravate the situation after an injury, it is important to clearly understand what to do with an ankle sprain. First of all, you need to fix the limb. This is mainly due to the fact that the characteristic signs of a sprain have much in common with the signs indicating a bone fracture. Therefore, it is best to keep the leg at rest until an accurate diagnosis is made. In addition, if this is still a fracture, then leaning on the leg can provoke displacement of the fragments.
To determine the integrity of the bone structure, it is not recommended to step on the foot or move it. You can use one of the first aid methods:
- Apply a cold compress. Only the ice should first be wrapped in some kind of cloth or towel. Bleeding will stop, the development of inflammation will be stopped. However, keep it for no more than 30 minutes.
- Take painkillers ("Analgin", "Ketanov", "Diclofenac"). How to relieve swelling on the ankle after sprain? In the absence of damage to the skin, you can use external means, that is, ointments.
- Ensure rest of the injured limb until diagnostic measures are taken.
A Grade I injury can be treated at home. The pain is not yet strong enough to interfere with movement. However, if a change in the configuration of the joint is detected, surgery may be required.
Sprain treatment
A sprain should only be treated after an accurate diagnosis, however, this rule applies to any disease.
After appropriate diagnostic measures, it is necessary to set the ankle, and the sooner the better. And, again, you should not perform such a procedure on your own. Manipulation is carried out by a doctor using local anesthesia.
After repositioning the bone on the damaged ankle, the doctor applies a circular bandage, which limits the possibilities of the joint. Sometimes a sprained ankle may require a cast. As for the period of wearing a bandage, it all depends on the severity of the injury. As a rule, this period lasts from two weeks to one month.
Full course of therapy for partial ligament injury includes:
- Using anti-inflammatory drugs or ointments.
- Taking painkillers if needed. Usually people who can't handle pain will need them.
- Means for resorption of hematomas.
- Carrying out therapeutic exercises, which will strengthen the ligaments and give them elasticity.
- Ensuring complete rest after injury, wearing an elastic bandage for sprained ankles.
In most cases, treatment is conservative. It usually heals on its own after a few weeks.
What not to do
There are the most common methods of therapy, which in this case should not be used categorically:
- rubbing with alcohol tinctures;
- carrying out thermal procedures;
- doing gymnastics when puffiness has not yet passed.
The main thing is to provide the ligaments with the opportunity to recover on their own due to their regenerative abilities. Premature exercise can lead to re-spraining of the ankle.
Surgery
Surgical intervention is performed with a partial, but more extensive or complete rupture of the ligaments. Usually this corresponds to II or III degree of stretching. During the operation, an incision is made on the skin, the condition of the cartilage is assessed. After that, the damaged fibers are sutured. In the event of a complete detachment of the ligament from the bone, it is fixed back. Finally, the wound is sutured with special threads, plaster is applied. It will have to be worn for approximately 7 days. Subsequent rehabilitation measures (physiotherapy, exercise therapy) are carried out after the removal of stitches for 10 weeks.
Just keep in mind that the operation is not yet a complete guarantee, since such a procedure has its own advantages and disadvantages. Among the advantages, one can note the possibility of a more detailed examination of the joint. Also, surgical intervention allows you to connect the ends of the ligaments, remove the hematoma and eliminate additional damage.
Cons: scars remain, nerve conduction is weakened, the cost of treatment is not so affordable. In addition, the rehabilitation period takes quite a long time.
