Tuesdays With Taylor! Episode 4: Ankle Sprains, stop the R.I.C.E.!

Taylor Premer, DC

June 5, 2019

A Quick Anatomy Lesson…

The most common mechanism of ankle sprains is an inversion movement. This puts a ton of stress on the lateral (outside) ligaments and muscles of the foot and ankle. Check out the picture for a good visual of these ligaments. The way our foot and ankle combines is an amazing display of engineering. We have 26 bones and 52 joints all joined with multiple tendons and ligaments. With this much “stuff” in the area, it can be difficult to identify what exactly the pain generator is. However, we can utilize our knowledge of anatomy along with some very specific tests to determine exactly what is injured and to what extent! This hands-on exam mixed with the patient’s recall of the injury will determine whether conservative care is the right call or if imaging is necessary to proceed with care. 

More on Imaging…

It is very rare that imaging is warranted in non-traumatic ankle injuries. In most cases, the most specific piece of information that leads us to order imaging is if the patient felt a distinctive “Pop” during the accident. This usually indicates a significant sprain of the ligament. However, sometimes the patient feels a pop, gets an MRI, and it comes back with a very minor sprain and no torn ligaments or fractures. These cases respond extremely well to conservative care and are usually back to full function in a few weeks. Ideally, we will see the patient as soon as possible following the injury so we can assess it and determine the specific course of action. The first several days following the onset of injury are crucial for speeding recovery up and ensuring no further damage is caused. 

Movement > R.I.C.E.

In the absence of torn ligaments and fractures, movement is the best course of action for recovery of ankle sprains. We actually do not utilize casting or booting of these patients and want them to weight bear and start moving as quickly as possible. During the initial inflammatory phase of the injury, we employ our passive modalities such as dry needling and acupuncture, short interval ice therapy (10 minutes on/30 minutes off during the first 24-48 hours), Class IV Laser, and kinesiology tape (K-Tape) in order to control the inflammation and increase the good nutrition to the site of injury. In these types of injuries, we do not want to completely eliminate inflammation. The inflammation helps provide the tissues with a constant supply of nutrition. However, if we do not keep these joints and tissues moving, the fluid can stay static and the tissues will not keep a constant flow. This delicate balance is what makes the doctors at Winchester Spine and Sport so special. We have special training in this area along with amazing modalities to assist us along the way!

If you or someone you know recently sprained their ankle or never recovered from a past one, send them this blog and encourage them to schedule an appointment with me!

I love helping people do what they love, pain-free!

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