Estimates show that every day 25,000 Americans sprain an ankle.
Problem: Patients and even some doctors don’t take this injury seriously enough, so it is among the most undertreated.
For this reason, one-third to one-half of all ankle sprains don’t completely heal, research shows. This can result in ankle instability and/or weakness that could lead to a lifetime of higher risk for falls… lingering pain… and recurrent sprains.
Solution: A simple regimen that focuses on the underlying inflammation caused by an ankle sprain can permanently heal this surprisingly dangerous problem.
WHAT GOES WRONG
An ankle sprain occurs when ligaments (fibrous bands of tissue that connect one bone to another) are stretched beyond their normal limits. With more severe sprains, the ligaments partly or completely tear. The area of bone where ligaments attach also can be damaged.
Most sprains can be treated at home. You need to see a doctor only if the pain increases significantly when you try to bear weight on the affected foot… there’s bruising and/or swelling involving an area larger than your fist… and/or the symptoms don’t start to improve within two or three days. Important: If you have any type of chronic joint or bone condition, see your doctor promptly.
HEALING WITH “RICE”
Many people are familiar with the “RICE” technique for treating sprains — it’s short for rest, ice, compression and elevation. It’s an important part of treating sprains, but few people do it correctly.
Mistake 1: Not resting the ankle — you should not put any weight on the ankle until it starts to improve. Use crutches — or, ideally, spend a day or two seated or in bed.
Mistake 2: While icing will reduce swelling and inflammation, which is critical for healing, many make the mistake of icing for too long. This increases tissue damage and inhibits circulation.
Better approach: Apply ice (wrapped in a washcloth) or an ice pack for 10 minutes starting as soon as possible after the sprain occurs. Remove the ice, and allow the tissue to return to your body’s normal temperature, about five minutes. Then ice it again for 10 minutes. Repeat this cycle for 20 to 40 minutes, three to four times the day of the injury.
This is the most effective way to reduce swelling and also promote the flow of blood and healing nutrients to the site of the injury.
Mistake 3: Not compressing the ankle sufficiently. Fixing the bones and ligaments in place helps a sprain heal more quickly. An elastic bandage works, but it is not perfect.
Better: An Aircast Air-Stirrup ankle brace with overlapping preinflated shells that immobilize the ankle and still allow enough movement to promote circulation. Wear at all times for four to seven days. Typical cost: $35 to $50 at a medical-supply store. Insurance may cover the cost if your doctor prescribes the ankle brace.
Mistake 4: Not elevating the foot high enough. Your ankle should be elevated above the level of your heart to promote the drainage of excess fluid.
Rest, compress and elevate your ankle for as long as you feel tenderness, typically one to three days.
EXTRA STEPS FEW PEOPLE TAKE
Even if you do the RICE technique appropriately, you also need to eliminate any traces of inflammatory substances that were produced by your body in response to the injury and rebuild the strength of your ankle. Next steps…
Contrast therapy. Dissolve about one-half cup of Epsom salts in a basin with a gallon of hot (102°F to 105°F) water. Soak a washcloth in the water, wring out excess water, and wrap the damp cloth around the ankle. Keep it in place for about five minutes. Then remove it and apply a washcloth that’s been soaking in ice-cold water. Keep it in place for about one minute. Repeat this cycle half a dozen times, every few hours throughout the day until your ankle feels better.
The heat causes protein and other nutrients to flow into the tissues. The cold causes the tissues to contract, which facilitates the removal of waste products, such as remnants of cellular damage.
Important: After 48 to 72 hours, press your fingers on the ankle, the heel and the side of the foot. If there’s still tenderness in these spots, see your doctor. Continued pain could mean that a sprained ligament has pulled away part of the bone, an injury known as an avulsion fracture. It usually heals on its own within a month or two, but sometimes surgery is needed.
Fish oil. Omega-3 fatty acids in fish oil reduce inflammation and help joint injuries heal more quickly — without the gastrointestinal upset and other side effects of naproxen (Aleve), ibuprofen (Motrin) and other anti-inflammatories. Typical daily dose: Fish oil capsules totaling about 800 mg of eicosapentaenoic acid (EPA) and about 500 mg of docosahexaenoic acid (DHA). Take until healing is complete.
Comfrey. This herbal remedy converts uric acid, an inflammatory substance that is produced after a sprain, into urea, a water-soluble substance that’s excreted in the urine. How to use: Apply comfrey-containing creams and ointments according to label instructions for up to 10 days.
Eggs. The yolks contain sulfur compounds that improve the elasticity of ligaments and help sprains heal more quickly. Eggs are also high in protein, which is needed to repair tissue damage.
Recommended amount: Eat about two soft-boiled or poached eggs every other morning or enough eggs so that there’s a slight odor of sulfur when you have a bowel movement. It’s fine to continue eating two eggs every other morning indefinitely.
Arnica (for swelling) and/or hypericum (for pain). Homeopathic doses of these herbs seem to help some patients with sprains recover more quickly. Dose: Two to three tablets with a 3X or 6X potency, taken three times daily until the ankle recovers.
Exercise. When the pain from a sprain is almost entirely gone, begin exercises to strengthen the muscles and ligaments and prevent future weakness…
Passive range-of-motion exercises are recommended initially. Cross one leg over the other, with the injured ankle on top. Reach down with your hand and move the foot in every direction up and down and in circles to exercise the ankle. Repeat this for at least five minutes, three times a day, until any lingering discomfort is gone.
Active range-of-motion exercises further strengthen the ankle. Use the muscles themselves to fully rotate and bend the ankle without assistance from your hand. Do these exercises as often as you can. You can also do slow walking with gradually lengthened strides.
Important: Also exercise your uninjured ankle with both types of exercises. This will give you a basis of comparison to determine when the sprained side is fully recovered. See your doctor if the sprained ankle continues to feel weaker or less stable than the other side after a few weeks of exercise.
