PERSONAL HEALTH

The Hazards of Ankle Sprains

By Jane E. Brody July 25, 2016 5:45 am

PERSONAL HEALTH
Jane Brody on health and aging.

Many fashion-conscious women wear high heels to show off their legs. But in
truth, given the extraordinarily high incidence of ankle sprains, wed probably all
be better off if we had thick stumps like an elephants to connect our feet to our
legs.

Every day in the United States, about 28,000 people sprain an ankle. Too
often the injury is dismissed as just a sprain, with no specific treatment and a
return to full activity before it has completely healed. Fully 45 percent of all athletic
injuries are ankle sprains, and players often go back into the game with little or no
treatment as soon as the pain subsides.

In fact, according to the International Ankle Consortium, a global group of

researchers and clinicians who study ankle injuries, 55 percent of people who
sprain an ankle never seek professional treatment in the aftermath of the injury.

Yet the majority of ankle sprains are doomed to recur. Thats because they
often result in a chronically unstable joint that tends to give way, poor balance, a
distorted gait, difficulty exercising, weight gain, diminished quality of life and early
arthritis. Not to mention the expense of dealing with health problems that can
result from being overweight and sedentary living.

Sound scary? It should, says Phillip A. Gribble, an athletic trainer at the

University of Kentucky and co-director of the International Ankle Consortium, who
hopes that knowing the potential consequences of ankle injuries will prompt more
people to treat them with respect and seek proper treatment. Even better, he said,
would be if more people took steps to prevent injury in the first place. And that,
ladies, may include leaving those spike heels in the store.

Dr. Gribble was one of several experts who recently presented the latest
technical information on ankle sprains to the National Athletic Trainers
Association meeting in Baltimore. In a study of 3,526 adults who responded to a
questionnaire, more than half, or 1,843, had previously sustained an ankle injury.
Those who had injured their ankles tended to weigh more, had greater limitations
in their daily activities and were more likely to have cardiovascular or respiratory
conditions than those who remained injury free.

While ankle sprains are most common among physically active people,
especially amateur and professional sports players and dancers, the general public
is hardly immune. The injury can result from walking on an uneven surface
(especially while wearing high heels or platform shoes), misstepping off a curb or
staircase, being pulled erratically by a dog on a leash, even playing around in the
yard with children or friends.

It doesnt take much. I know years ago, I sustained two bad sprains, one
stepping on a stick while trimming a hedge and the other missing the last step
while exiting a plane in the dark. I am now extremely careful about where I walk
and what I put on my feet, especially when hiking in the woods (boots are de
rigueur).

Most ankle sprains result when the foot abruptly turns in under the leg so that
the sole of that foot faces the opposite leg, unduly stretching the ligament on the
outside of the ankle. The extent of the injury can range from a minor strain to a
complete tear, and the rate and extent of healing can vary greatly.

In one report to the athletic trainers convention, 12 college students who had
sprained an ankle still had an incompletely healed, overstretched ligament a year
after the injury, which may explain the high percentage of patients that develop
chronic ankle instability, said Tricia Hubbard-Turner of the University of North
Carolina at Charlotte.
 Even though fewer than half of ankle sprains receive medical attention, the
injury is so common (an estimated incidence of 2.06 ankle sprains per 1,000
people a year) that it is the leading lower extremity injury that results in an
emergency room visit, according to data from the National Electronic Injury
Surveillance System.

As with any injury, ankle sprains are best prevented. One of the best
approaches is to improve ones balance with exercises that train the body to stay
upright and maintain control in all kinds of positions. Dr. Gribble recommends
spending time standing on one foot, at first on a firm surface, then with eyes
closed, then on a soft surface like a pillow. As a final challenge, practice balancing
on a wobble board, he said.

Muscles surrounding the ankle can be strengthened by wrapping a towel

around the foot for resistance, then moving the foot up, down, in and out. Do
stretching exercises that increase the flexibility of the legs, hip and torso to guard
against any unanticipated awkward movements.

When participating in sports like basketball, soccer and tennis which

involve jumps or quick changes in direction that can put ankles at risk consider
taping or bracing the ankles to increase their stability.

Finally, avoid being a weekend warrior who indulges in a sport full tilt without
adequate preparation. Build up gradually, practice the skills involved and make
sure to keep needed muscles strong.

Should you sprain an ankle, avoid the all too common laymans advice to walk
it off. At a minimum, leave the game or whatever you were doing and avoid
putting weight on that foot to give the injured joint adequate rest. If the injury is
severe, you may need to use crutches.

If you do sprain an ankle, apply ice wrapped in a cloth for 15 to 20 minutes

every two or three hours for two days, then once a day until pain and swelling are
gone. Sit or lie down as much as possible with the injured ankle elevated above the
hip. To further minimize swelling, wrap the ankle in an elastic bandage, starting at
the toes and working up to the leg.
 Seriously consider a medical consultation, especially if pain and swelling
persist for more than a few days. Although in most cases, an X-ray or M.R.I. is not
needed to make an accurate diagnosis, the injury could be more serious than a
simple sprain. Ask about physical therapy, which can strengthen the joint and help
prevent reinjury.

Most important of all, dont rush back into activity before healing is complete
and normal, pain-free range of motion has been restored. Reinjuring the ankle can
result in permanent pain and disability and the health consequences noted above.

Related:

Science Weighs In on High Heels

12 Minutes of Yoga for Bone Health
The Health Benefits of Knitting

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A version of this article appears in print on 07/26/2016, on page D5 of the NewYork edition
with the headline: Learning to Prevent Ankle Sprains.

2016 The New York Times Company