Coordination and amortization of movements when walking, running and jumping is provided by the ankle joint together with the foot. At the same time, it constantly contacts the surface and experiences multidirectional shock loads. Therefore, he is often injured not only by athletes, but also by those who are far from sports. Most of these injuries are sprains of varying degrees.
The reasons
Sports activities associated with fast and abrupt movements, jumps and falls often lead to excessive and unbalanced load on the legs. Therefore, for such athletes, sprains of the ankle or ankle are one of the most common injuries. In ordinary life, such damage occurs when using shoes that do not correspond to the terrain or type of activity.
Being overweight and underdeveloped muscles also increase the risk of falling, bruising, or twisting the foot. Congenital joint degenerative changes, acquired as a result of trauma or surgery, can provoke serious consequences from an unsuccessful jump or walking on an uneven surface.
Stretching ratios
Ankle injuries, depending on the severity, are divided into:
- Lungs (first degree) - there is a partial rupture of soft tissues at the junction of the ligaments and muscles. Pain is weak and manifests itself with load and movement of the joint, which is slightly limited in mobility. The leg does not lose its support function.
- Medium (second) - a significant number of ligament fibers are destroyed. At the first moment, a sharp pain occurs, which subsides much over time and can last for several days. It's almost impossible to step on your feet. Ankle movement is almost partially blocked by pain and severe swelling.
- Severe (third) - characterized by complete rupture of ligaments or tendons and acute pain that does not pass for a long time. Symptoms are similar to fractures of the bones of the joint - it completely loses its mobility and support functions.
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Ankle sprain symptoms
With minor injuries, pain may appear only the next day. There is a slight swelling of the joint. Local hemorrhage may occur at the site of injury. Support on the leg is made difficult by minor pain. Joint mobility is weakly limited.
In more difficult cases with severe pain, you should immediately contact a medical specialist in order to establish the exact cause and prevent severe consequences from repeated injuries in the event of a fracture.
With a second or third degree sprain at the time of injury, severe pain may be accompanied by a characteristic crunch or click. It does not disappear even in a calm state. When pressing on the damaged area or rotation of the foot, it sharply aggravates. A complete rupture of the ligaments leads to the rapid appearance of edema and hematoma, a local increase in temperature. The joint acquires abnormal mobility. All movements are blocked by severe pain and a change in the relative position of the joint parts. The leg partially or completely loses its support function.
Diagnostics
At the initial examination, first of all, the severity of the damage is determined using palpation and stress tests, which are carried out to exclude an X-ray examination for the presence of a fracture. If these methods cannot establish the cause, then X-rays of the ankle are taken in three planes. Also, the feasibility of such a study is determined using the Ottawa rules for examining the ankle: if the victim cannot bear the body weight, taking four steps, then further clarification of the diagnosis is required, and the probability of a fracture is high (95-98%).
To clarify the condition of the ligaments, soft tissues and identify hidden hematomas, magnetic resonance imaging or computed tomography is prescribed.
First aid
First, measures are taken to relieve pain and reduce swelling with a cold compress and pain relievers. Then the injured limb must be placed on a comfortable hill and the joint must be immobilized. To do this, you can use a bandage, splint or a special bandage.
With an average degree of damage, you need to consult a doctor to clarify the diagnosis and prescribe treatment. In case of acute pain and suspicion of a fracture, an ambulance should be called immediately.
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Treatment
For minor sprains of the ankle or ankle (first or second degree), a tight bandage or kinesio taping in combination with partial or complete limitation of the load for one to two weeks is sufficient. For the first few days, cold compresses and analgesics are used to relieve pain and reduce swelling. Then anesthetic and anti-inflammatory ointments are applied to the injury site.
Nise gel has a good local anesthetic effect.
On the second or third day, physiotherapy procedures (UHF, magnetotherapy, laser treatment) and various warming up procedures (paraffin compresses or isokerite) are prescribed. If it is possible to step on the foot, it is allowed to start walking and perform the simplest exercises: wiggling toes, turning and rotating the foot.
In more severe cases, hospitalization and surgical intervention may be required, after which long-term conservative treatment (2-3 months) is carried out and the lower leg is fixed with a plaster cast until the ligaments are completely healed.
What not to do when stretching the ankle
Before relieving pain, you should not load your leg, and for the first few days, do not use warming ointments and compresses, do not take hot baths and do not visit baths and saunas. To avoid congestion and atrophy of muscles and ligaments at night, it is necessary to remove the pressure bandage. If you experience severe pain while walking or exercising, immediately remove the load and ensure long rest.
Rehabilitation
If you do not fully restore the performance of all elements of the articulation, then the sprain of the ankle joint can become a serious obstacle to an active lifestyle and sports. Therefore, immediately after the severity of the pain syndrome, swelling and healing of the ligaments has been relieved, therapeutic exercises and massage are necessarily prescribed. At the initial stage, the joint is stabilized with an elastic bandage or a special fixation device. The load and range of exercise increase gradually as the muscles strengthen and the ligaments and tendons stretch.
Any workout begins with a warm-up.
Depending on the degree of damage, full recovery of the ankle's performance lasts from two weeks to four months.
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Medication
The main task in the treatment of such injuries is to relieve pain, swelling, eliminate hematomas and restore the integrity of the ligament fibers. For this, non-steroidal analgesics, anesthetic and warming ointments and gels are used orally. In case of problems with the gastrointestinal tract, intramuscular injections may be given. For faster recovery of ligaments, a balanced diet and saturation of the body with microelements and vitamins is necessary.
How to apply an ankle strap correctly
Before applying the bandage, you must ensure the correct position of the foot. If the ligaments are damaged:
- Calcaneofibular, anterior and posterior talofibular - the plantar side is taken out.
- Deltoid - the plantar side is taken inward.
- Tibiofibular - the foot is slightly bent.
The limb is bandaged from a narrow part to a wide one, in the form of a figure eight: first on the ankle, and then on to the foot. Each layer is wound without wrinkles and folds and should overlap the previous one. It is necessary to control the degree of tension so as not to pinch the blood vessels, while at the same time ensuring a secure fixation of the joint. The procedure ends on the ankle, and the bandage is fixed on its outer side.
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Prevention
To reduce the risk of injury, you can:
- Careful selection of shoes that securely fix the joint.
- Constant training of muscles and ligaments of the ankle.
- Control of loads when performing exercises and mastering the technique of their performance.
- Maintaining good physical shape and improving motor coordination.
- Weight normalization.
