Ankle sprain – symptoms and treatment

Sprain of the ankle joint occurs with a sharp movement of the foot in a direction unusual for her. Damage is manifested by pain, swelling and impaired motor function. The severity of symptoms depends on the degree of damage to the connective tissue. First aid immediately after the incident facilitates further treatment. The complex of therapeutic procedures includes medications and physiotherapy methods. For the full restoration of the ankle joint, it is important to conduct physical therapy classes.

Shishkevich Vladimir, orthopedic Shishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews.

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Anatomical features

Ankle joint is the connection of the bones of the lower leg, covering the talus on both sides in the form of a fork. The mobility of the block-like joint provides a complex ligamentous apparatus consisting of four cords covering the joint from all sides.

The physiological ability to withstand heavy loads during intense running or jumping and to make movements in two planes is supported due to the properties of the ligaments. The connecting fibers have a unique ability to stretch during direction or braking when moving.

Sprain of the ankle joint occurs with extreme stretching of the connective tissue, exceeding its physiological characteristics. A sharp turn of the foot in a direction unusual for the foot leads to the fact that the ligament pathologically stretches with the formation of mechanical microdamages. In severe injuries, an ankle ligament rupture occurs.

Causes

Stretching is a direct consequence of the sudden movement of the lower limb when the foot is inverted inward or outward. With intense running, the front of the leg suffers when a person lands on the upper part of the foot. In any case, the degree of stretching depends on the speed of the jerk and the weight of the victim.

No person of any age or gender is safe from injuries. It is possible to reduce the risk of violation of the anatomical structure of the ligament with awareness of the factors that provoke this type of injury:

  • a large load on the joint associated with fast running or jumping;
  • weakness of the ligamentous apparatus due to a genetic predisposition or lack of fitness of the lower extremities;
  • uncomfortable high-heeled shoes, platforms, absolutely flat sole on ballet shoes, worn-out deformed soft shoes or sneakers;
  • carelessness when walking on an uneven surface in the forest, mountains;
  • athletes involved in winter sports, poorly laced shoes become the cause of awkward falls;
  • obesity;
  • weakened ligaments due to degenerative changes in the joint with arthrosis or the influence of an age factor;
  • violations associated with improper placement of the foot or omission of the longitudinal and transverse arches, flat-valgus or varus deformity;
  • lack of correction of a shortened limb.
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Symptoms

At the time of injury, the sufferer feels pain, in some cases, accompanied by a loud bang. Clinic manifestations of stretching reaches its strength a few hours after the disaster. Immediately after the incident, a person can move independently until the innervation reaction reaches its peak.

The main symptoms that accompany an injury of any severity include:

  1. pain syndrome;
  2. swelling;
  3. subcutaneous hemorrhage;
  4. deformed deflection of the foot in relation to the lower leg;
  5. local increase in body temperature.

Ankle sprain according to the degree of damage can be divided into three forms:

  1. A slight degree of trauma does not lead to a violation of the integrity of the ligament, stretching is manifested by microscopic cracks in the connective tissue. You can get this type of injury if a person stumbles while walking at a slow pace. The victim complains of mild pain, gaining intensity when trying to lean on a damaged leg. Around the ankle there is a slight swelling without the formation of a hematoma. A person retains the ability to move independently with the help of a support in the form of a cane or crutch.
  2. An average degree of stretching is diagnosed when tears appear on the collagen fibers. A sharp pain pierces the ankle during an injury, a person falls and cannot move on. Severe edema appears at the site of damage, the skin over the joint partially turns blue due to subcutaneous hemorrhage. Often, the foot assumes a pathological position with respect to the lower leg, shifting inward. Deformation completely disappears after treatment.
  3. Severe injury – rupture of the ligament or its complete separation from the place of attachment to the bone. Complete damage to the ligamentous cord is accompanied by a loud click of torn tissue. Pain syndrome of high intensity, edema of such strength appears that the ankle joint under the accumulated fluid is not visually determined. Cyanosis under the skin manifests itself gradually, giving way to shades of yellow and purple. The joint becomes pathologically mobile and unstable. The general condition worsens, a person may develop a condition resembling a collapse: the skin turns pale, blood pressure drops, chills and cold, sticky sweat appear.

First Aid Stretching

Correct actions before the doctor arrives after an injury contribute to a quick recovery, and prevents the possibility of deterioration. Initially, after what happened, it is necessary to reassure the victim and examine the ankle area for possible deformations, open injuries that may indicate a fracture or complete rupture of the ligaments.

For preliminary diagnosis, you need to slightly press on the bone area above the joint by 7 cm. If the pain intensifies, then it is better to leave the leg at rest without a pressure bandage so as not to aggravate the injury. If such symptoms are not observed, the algorithm of actions follows the standard procedure for providing assistance:

  • Release the injured leg from shoes and hosiery using scissors so as not to exert force during the manipulation.
  • Position the leg in an elevated state above the area of ​​the heart to reduce swelling.
  • Bandage the damaged joint tightly with an elastic bandage, grabbing a figure-eight foot. The dressing will create a small compression effect, which will prov >

Diagnostics

The severity of the injury is determined by an appointment with a traumatologist. After an external examination, diagnostic measures are carried out to confirm the assumptions, with the help of which you can examine in detail the nature of the damage.

An x-ray when stretching the ankle joint is carried out in two projections. Magnetic resonance imaging allows you to consider not only bone tissue, but also changes in cartilage.

Arthrography using nitrous oxide or a heavy highly atomic substance as a contrast. Any changes are clearly visible after artificial contrasting of the components of the joint.

Treatment

Therapeutic stretching procedures are aimed at eliminating the effects of trauma and restoring movement function. The basic principle on which the healing of connective tissue is based, ensuring complete rest of the diseased leg.

The degree of stiffness of the immobilizing dressing depends on the nature of the injury. The stronger the damage, the more motionless the ankle joint should be. To ensure this measure, gypsum is applied or the dressing is formed from polymer bandage. An alternative is a rigid orthosis equipped with metal stiffeners.

If the sprain is moderate or mild, the ankle joint is tightly bandaged with a highly extensible elastic bandage. For convenience and ensuring proper compression, orthopedists are prescribed to wear a bandage in conjunction with preventive orthopedic insoles to reduce the load on the stretch.

In the first two days, the leg must be maintained in an elevated position, which is used to prevent edema. It is strictly forbidden to use warming ointments or compresses, due to which the inflammatory reaction can join. Cold is applied every 2 hours for 10 minutes, which reduces edema and reduces the manifestations of hematoma.

Medicinal products

  1. Nonsteroidal anti-inflammatory drugs (Ketorolac, Nise, Nemesil) are prescribed to relieve pain and inflammatory reactions. Only a doctor can prescribe drugs. The drugs are used in the form of tablets, powders for oral administration, injection. External use in the form of ointment or gel is used on the third and subsequent days – Voltaren, Finalgon, Dolgit, which have a warming effect. Nise, Dolobene – can be used immediately after an injury, drugs will not only anesthetize, but will also remove fluid that has accumulated in the area of ​​the injury.
  2. Glucocoricosteroids (prednisone, hydrocortisone) are most often used in injections to prevent allergic reactions, severe swelling and inflammation.
  3. Analgesics (Analgin, Tempalgin, Pentalgin) have an analgesic effect in case of injuries.
  4. Treatment of hematomas is carried out by external means – Troxerutin, Troxevasin.

Complete ligament ruptures that are not amenable to conservative treatment methods are eliminated by surgical intervention. Arthroscopy, suturing on torn ligaments is practiced.

Physiotherapy

Additional methods of treatment after injury act in combination with drugs, enhancing the effect of traditional medicine. In the acute period, electrophoresis is possible with painkillers (Novocain, Lidocaine) or steroid hormones (Diprospan, Dexamethasone).

Exposure to the joint with a laser beam improves blood circulation and enhances the circulation of lymphoid fluid. Point cryotherapy is designed to relieve pain and prevent inflammation. Magnet treatment is prescribed primarily during the rehabilitation period.

Massage courses during the recovery period improve blood flow, the state of muscle fibers, and also increase the amplitude of movements. Physical therapy is regularly carried out under the supervision of an instructor for a complete recovery.

Prevention

Measures to prevent injuries include:

  • the use of comfortable shoes for everyday wear and sports;
  • when performing intensive exercises, put on a preventive bandage on the ankle;
  • proper nutrition and a healthy lifestyle will strengthen the ligamentous apparatus and maintain a beautiful gait for a long time;
  • After an injury of any severity, it is necessary to contact the trauma center to determine the nature of the damage
  • strictly follow medical recommendations for recovery after ankle sprain.
Morozov Georgiy

Rheumatologist. For more than 20 years, he has been involved in the diagnosis, treatment and prevention of joint diseases. Specialization: diagnosis, treatment and prevention of diseases and deformations of the musculoskeletal system.

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