Ankle Sprains and Strains

It might not make much of a storyline on a TV medical drama, but ankle sprains are one of the most common reasons for an emergency room visit. The American Orthopaedic Foot and Ankle Society (AOFAS) estimates that 27,000 people sprain an ankle in this country every day. That's a lot of ice packs.

Do you have to worry about twisting, turning, or otherwise injuring your ankle? You do if you have suffered an ankle sprain in the past, according to Carol Frey, M.D., an orthopedic surgeon in Los Angeles. "You are two times more likely to sprain your ankle if you have sprained it before. Most people never rehab the injury completely, and the ligaments don't heal properly.''

You can do a simple exercise to strengthen the weakened joint. And if you have never sprained an ankle, it can increase the odds that you won't.

Tube it

Sit with your legs straight out in front of you. Place a towel or an exercise band or even an old inner tube around the ball of your foot like a stirrup. Point your toe away from your body, working against the resistance. Repeat 20 to 30 times.

Stretch it

Keep your Achilles tendon flexible. A tight tendon equals an unstable ankle. Use the classic runner's stretch with your arms against a wall, your leg behind you and your toes pointed slightly in. Or, with the toes of one foot on a stair or curb, dip your heel down.

Increase proprioception (proprio what?)

That is a fancy term for having a sense of where your foot is when you aren't looking at it. Stand on the injured leg like a crane with eyes closed. Balance for 30 seconds.

Support it

Shoes are all-important. Make sure they aren't worn out. Put them on a counter and look at them from behind. "If they are leaning to one side without you in them, they are unstable and should not be worn,'' Dr. Frey says.

Other shoe don'ts?

"Stiletto heels and wearing $150 sneakers but not lacing them up,'' says Glenn B. Pfeffer, M.D., an orthopedic foot and ankle specialist in Los Angeles.

RICE is nice

If you do injure your ankle, treat mild sprains with the RICE method:

• Rest (staying off the injured body part)

• Ice (applying ice packs for 20-minute periods)

• Compression (wrapping the ankle)

• Elevation (raising it above your heart to lessen swelling)

Use ice for 20 minutes each hour for the first 24 to 36 hours. Then apply heat compresses for 20 minutes at a time, several times a day. This causes a "washing'' effect in the injured area, bringing blood in, which promotes healing. According to Dr. Pfeffer it can take three to four months to completely recover from an ankle sprain. The exercises described above can be used to avoid a recurrence of the injury. "You shouldn't just treat the symptoms," he says, "but try to look for the causes and avoid them.''

Severe sprains

See a doctor if you can't put any weight on the ankle. Depending on your injury, treatment may range from pain control to immobilization of the joint with a splint or cast. In most cases, surgery isn't needed—multiple studies have shown that ankle sprains are best treated without surgery. In rare cases, people with recurrent sprains may benefit from surgery.

You may need to use crutches temporarily if your foot can't support weight. Depending on the severity of the sprain, your ankle may hurt for a month or more.