Nonoperative:
Most "high" (syndesmotic) ankle sprains can be treated in a manor similar to typical ankle sprains with PRICE. P: Protection from further injury via a splint, R: Rest, I: Icing, C: Compression wrapping, E: Elevation (see sprained ankles). Syndesmotic sprains, however, will require much longer to heal and will also need more physical therapy to strengthen the muscles around the ankle.
Operative: Severe "high" (syndesmotic) ankle sprains with significant displacement of the bones (Tibia and Fibula) require surgical stabilization.
Call Immediately For Emergency Medical Assistance if
a) a broken bone is suspected or if there has been a serious injury or persistent pain.
b) there is an audible popping sound and immediate difficulty in using the joint.
How to Rehabilitate
Rehabilitation can begin a few days after the injury, when the swelling starts to go down. There are three goals to aim for in rehabilitation.
1. Restore motion and flexibility. Gently move the ankle up and down. After 5 to 7 days, start restoring motion to the hindfoot by turning the heel in and out.
You should also begin to restore flexibility to the calf muscles. One way to do this is to face a wall with one foot in front of the other and lean forward with your hands on the wall, bend the front leg while keeping the back leg straight and both heels on the floor. Lean forward until you feel a gentle stretch, and hold for ten seconds. Switch legs and repeat.
2. Restore strength. After 60 to 70% of the ankle?s normal motion has returned, you can begin strengthening exercises using a rubber tube for resistance. Fix one end of the tube to an immovable object like a table leg, and loop the other end around the forefoot. Sit with your knees bent and heels on the floor. Pull your foot inward against the tubing, moving your knee as little as possible. Return slowly to the starting position. Repeat with the other foot.
You can also sit on the floor with your knees bent and the tube looped around both feet. Slowly pull outward against the tube, moving your knee as little as possible. Return slowly to the starting position. Repeat with the other foot.
3. Restore balance. As strength returns, balance is restored by standing on the injured leg, hands out to the sides. You may want to warm the ankle before doing these exercises by soaking it in warm water. Warmed tissue is more flexible and less prone to injury. Use ice when finished with the exercises to minimize any irritation to the tissue caused by the exercise.
When Can I Return To Sports?
Return to sports only after you have met these goals:
1. You have full range of motion in all directions (up and down, side to side, and in and out).
2. You have good strength in all muscles around the ankle.
3. You have good balance.
4. You have no pain or swelling with exercise or activity.
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Most "high" (syndesmotic) ankle sprains can be treated in a manor similar to typical ankle sprains with PRICE. P: Protection from further injury via a splint, R: Rest, I: Icing, C: Compression wrapping, E: Elevation (see sprained ankles). Syndesmotic sprains, however, will require much longer to heal and will also need more physical therapy to strengthen the muscles around the ankle.
Operative: Severe "high" (syndesmotic) ankle sprains with significant displacement of the bones (Tibia and Fibula) require surgical stabilization.
Call Immediately For Emergency Medical Assistance if
a) a broken bone is suspected or if there has been a serious injury or persistent pain.
b) there is an audible popping sound and immediate difficulty in using the joint.
How to Rehabilitate
Rehabilitation can begin a few days after the injury, when the swelling starts to go down. There are three goals to aim for in rehabilitation.
1. Restore motion and flexibility. Gently move the ankle up and down. After 5 to 7 days, start restoring motion to the hindfoot by turning the heel in and out.
You should also begin to restore flexibility to the calf muscles. One way to do this is to face a wall with one foot in front of the other and lean forward with your hands on the wall, bend the front leg while keeping the back leg straight and both heels on the floor. Lean forward until you feel a gentle stretch, and hold for ten seconds. Switch legs and repeat.
2. Restore strength. After 60 to 70% of the ankle?s normal motion has returned, you can begin strengthening exercises using a rubber tube for resistance. Fix one end of the tube to an immovable object like a table leg, and loop the other end around the forefoot. Sit with your knees bent and heels on the floor. Pull your foot inward against the tubing, moving your knee as little as possible. Return slowly to the starting position. Repeat with the other foot.
You can also sit on the floor with your knees bent and the tube looped around both feet. Slowly pull outward against the tube, moving your knee as little as possible. Return slowly to the starting position. Repeat with the other foot.
3. Restore balance. As strength returns, balance is restored by standing on the injured leg, hands out to the sides. You may want to warm the ankle before doing these exercises by soaking it in warm water. Warmed tissue is more flexible and less prone to injury. Use ice when finished with the exercises to minimize any irritation to the tissue caused by the exercise.
When Can I Return To Sports?
Return to sports only after you have met these goals:
1. You have full range of motion in all directions (up and down, side to side, and in and out).
2. You have good strength in all muscles around the ankle.
3. You have good balance.
4. You have no pain or swelling with exercise or activity.
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