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Ankle Injury

Of all the joints in the body, none is as complex as the ankle. Its intricate structure of bones, tendons, and ligaments is under the control of an equally complex group of muscles. The variety of movements performed by the ankle subject it to forces of a magnitude far out of proportion to its size. It is little wonder that ankle injuries are the most common of all Slip, Trip or Fall injuries.

When the ligaments that stabilize the ankle are overstretched or torn, the result is a sprained ankle. Inversion sprains are by far the most common type. These occur when the foot abruptly turns inward, putting tremendous stress on the ligaments on the outside of the ankle. Eversion sprains, with stretching of the inside ligaments when the foot turns outward, are much less common. Mild sprains, in which the ligaments are stretched only slightly beyond their normal limits, usually require minimal attention - if the pain and swelling are so mild as to permit normal weight bearing. More severe sprains are quickly evident, with marked swelling, sharp pain, and evidence of bleeding under the skin. The worst sprain is one producing a complete tear of the ligament, putting the joint completely out of commission. Sometimes what appears to be an ankle sprain is really a fractured bone. This can be of either the end of one of the long bones of the lower leg, the fibula, or a fracture of one of the bones of the foot. Thus, care must be taken with an injured ankle to make sure exactly what is injured.

The symptoms of an ankle sprain are pain, tenderness, and swelling, usually occurring within the first few minutes of the injury. Sprains are graded as mild (the ligament is strained or overly stretched), moderate (partially torn ligament), or severe (a complete tear, meaning that the ligament can no longer control the ankle joint). If the swelling and pain are slight and you can put weight on the ankle, the sprain is mild and you may not need medical attention. If you heard a popping sound when you sprained your ankle, if the ankle looks abnormally bent, and/or if the swelling is severe and the skin discolored, you should suspect a severe sprain or even a fracture and see a doctor or go the emergency room as soon as possible. Not all sprained ankles need to have x-rays to determine the nature of the injury. This depends upon the symptoms and signs as determined by your doctor or other health professional.

Most sprains heal without complications, although the risk of subsequent sprains increases because of weakened and less flexible ligaments. About ten days is required for healing of a minor sprain, but full motion in the joint takes longer. Rehabilitation includes special exercises to help reduce swelling, prevent stiffness and regain flexibility, and regain strength. It is best to refrain from returning to full activity before complete healing of the ankle has occurred in order to avoid reinjury and possible complications. A moderate ankle sprain may require 3 to 6 weeks of rehabilitation before the area is fully healed, and a severe ankle sprain can take 8 to 12 months.

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