A simple misstep can cause a sprain. It usually is a quick movement whereby the foot twists sideways. This can occur with both the layman on the street and the athlete. In the case of the layman, many Trinbagoians may tease saying that the person is clumsy.

However; it is generally a function of body misalignment (while most of us are misaligned, seniors are more so inclined), uneven/wet surfaces, mis-averaging a curb/landing or, unsupported/high heeled shoes. In the case of athletes, events/training such as jumping and running make them prime candidates. Other susceptible persons are hikers and extreme sport personnel (zip liners, bungee jumpers).

Types of Sprains

· The inversion or lateral ligament sprain – It's the most popular; the ankle turns over so the sole of the foot faces inwards, damaging the ligaments on the outside of the ankle.

· An eversion ankle sprain - Can occur particularly with a fracture, but is rare. In this case the ankle rolls the other way, so the sole of the foot faces outwards, damaging the ligaments on the inside of the ankle.

· Damaged anterior talofibular ligament - This ligament, as the name suggests, connects the talus (ankle bone) with the fibula (smaller of the two bones in the lower leg). It's also common.

· Damaged calcaneofibular ligament – It connects the heel bone to the fibula further back towards the heel. This ligament only becomes injured in more severe injuries due to its increased strength and laxity whilst the toes are pointed (a common position for ankle sprains).

In addition to the ligament, in more severe cases, there could be damage to tendons, bone and other joint tissues.

Symptoms

Swelling and bruising are the main symptoms associated with an ankle sprain. The degree of symptoms tends to correlate with the extent of the damage to the ligaments.

Grade 1 Sprain

· Some stretching or perhaps

minor tearing of

the lateral ankle ligaments.

· Little or no joint instability.

·  Mild pain.

·  There may be mild swelling

around the bone

on the outside of the ankle.

· Some joint stiffness or difficulty

walking or running.

Grade 2 Sprain

· Moderate tearing of the ligament fibres.

· Some instability of the joint.

· Moderate to severe pain and difficulty

walking.

· Swelling and stiffness in the ankle joint.

· Minor bruising may be evident.

Grade 3 Sprain

· Total rupture of a ligament.

· Gross instability of the joint.

· Severe pain initially, followed later by

no pain.

· Severe swelling.

· Usually extensive bruising.

When to check your physician or an

orthopaedic specialist

If your symptoms include:

· Inability to walk on the

ankle

· Significant swelling

· Symptoms that do not improve quickly or persist beyond a few days

· Pain in the foot or above the ankle

· Numbness of the toes

Differentiating between a sprained ankle and an ankle fracture can be difficult, and sometimes an x-ray is needed. If you think you may have done more than sustained a sprained

ankle,seek immediate care.

Treatment

Treatment can be separated into immediate first aid, longer term ankle rehabilitation, and ankle strengthening. Here are a few points:

· Aim to reduce the swelling through RICE (Rest, Ice, Compression, Elevation) as soon as possible.

· Do Range of Motion

Exercises

· Do

Strength Exercises

· Do Toe Raises

· Do Heel and Toe Walking

· Do Activity Specific Training

· Wear an Ankle Support/Brace

Surgery

Patients who have chronic, recurring ankle sprains usually have loose ligaments that need to be tightened. The most commonly performed surgery to repair these ligaments is called a Brostrom repair. In this surgery, the ligaments on the outside of the ankle are tightened, and the thick tissue around these ligaments, called the retinaculum, is advanced. This procedure prevents the ankle from being unstable. Unstable ankles are generally assessed via physical examination or x-ray.

Other Things that can be done

· A doctor may prescribe anti-inflammatory medication to help with pain and swelling.

· Swelling may be reduced by compression devices or ankle taping techniques.

·     Laser/electrical treatment could be used to reduce pain, inflammation, and promote healing.

· Cross-friction massage may be done to promote healing and reduce scar tissue development.

·  Pursuit of a full ankle rehabilitation programme to strengthen the joint and help prevent future ankle sprains.

Your feet mirror your general health, cherish them!

Leana Huntley is an English trained foot health practitioner attached to ALMAWI Limited – The Holistic Clinic. Call to make an appointment at 662-1732 or lhuntley@almawiclinic.com Tuesday - Saturday. Check for the Clinic at www.almawiclinic.com.