By Dev Mishra, M.D.
President, Sideline Sports Doc
Clinical Assistant Professor of Orthopedic Surgery, Stanford University
- Significant swelling, any bruising, or inability to bear weight might indicate a more severe ankle injury. Get an evaluation from an orthopedic surgeon or sports medicine physician for the proper diagnosis
- Many ankle sprains are undertreated, meaning that they are not properly rehabilitated
- Good rehab with a physical therapist for more significant ankle injuries can get you back to sports faster and decrease chances for another injury
An ankle sprain typically happens when the ankle rolls inward following landing from a jump, as in basketball or volleyball, or forceful contact with the bag in baseball or softball. This stretches the ligaments on the outside of the ankle. This is such a common type of athletic injury that it is often undertreated and the athlete can have a chronic problem. It’s important to adequately assess the injury and form a treatment plan that will ensure a prompt and safe return to sports and also ensure that an athlete will have no long-term problems.
Many ankle sprains in young athletes will be mild injuries with little to no swelling and only mild discomfort. These will often improve with RICE (rest, ice, compression, elevation) and allow the player to return to sports after a few days. But some injuries can result in a very swollen ankle, bruising, and difficulty weight bearing. In those instances it’s best to see a sports medicine physician or orthopedic surgeon for a proper diagnosis. This could be a growth plate injury, a bone fracture, or a more severe ankle sprain.
After being evaluated for any bone or excessive ligament damage, the treatment plan will be started. The first stage is to continue the ice, compression, and elevation to minimize the swelling. Sometimes taping or an ankle splint may be used to relieve the pain and reduce further swelling.
As the athlete can gradually bear weight to tolerance, it is also important to start range- of-motion and strengthening exercises. This is where I tend to recommend working with a skilled physical therapist. The therapist can usually start strengthening and coordination exercises that will get the athlete back in shape quickly. I also find that restoring balance is very important in restoring sport specific skills and in reducing the chance for a repeat injury. You’ll be doing a lot of “homework” too, such as work with elastic bands for strength and alphabet writing with the toes for motion. You might find some of these exercises a bit boring but they work!
When an athlete comes to the office with multiple past sprains we often find that they did not go through the proper rehabilitation in their previous sprains. Good rehab is the missing link in these cases. Cutting corners can lead to ongoing issues that make you susceptible to repeated injuries. The right rehab will get you back to playing faster and should decrease chances of reinjury later on.