Ankle problems are familiar to athletes and lay people. The joint itself can withstand the load of weight during rest and intensive training. The treatment scheme for ankle sprains provides, in addition to traditional methods (bandages, therapeutic gels, ointments), modern methods for rapid rehabilitation.
The tibia takes over the entire load, provides the necessary mobility of the foot. Separate the tibia and fibula connected by a membrane. Closer to the foot is the talus, connected to the heel skeleton. Ligaments are responsible for the operability and mobility of all these structures. Medicine distinguishes between the concepts of tendon and ligament: the former provide adhesion of muscles and bones, the latter “hold” the bones.
When the ligaments are stretched, a partial rupture of the connective tissue between the constituent parts of the joint occurs. Typically, lesions are localized on the external region of the ankle. The cords hold the joint in a “stable” position, limiting sharp movements on the sides. The number of injured compounds depends on the assessment of the severity of the damage. Treatment for sprain of the ankle should be started immediately to avoid complications after an injury.
Causes of Injury
Different types of ankle ligament injuries (sprain, tears, tears) appear in athletes in the following cases:
- a large load on the muscle tissue of the lower leg;
- tucking the feet while running or walking fast;
- sudden movement of the joint;
- poorly selected sports shoes;
- sudden muscle weakness (for example, after a recent illness).
To be precise in terms, the treatment of ankle sprain is a rupture therapy. Ligaments do not stretch, with great effort they partially or completely break. With a small number of injured fibers, they speak of tension. In this case, the joint moves almost like before an injury. If less than 50% is damaged, a tear is diagnosed. In the case of a more extensive injury, we are talking about a gap – a complete separation of the ligaments from the bone.
Damage with a gap occurs with a sharp change in the position of the foot – bending inward if a person suddenly fell to one side (with improper landing). In these cases, the strength of the ankle muscles does not support body weight, the entire load is on the fibers connecting the articular bones. Movements around the axis of the joint are some of the traumatic. To exclude ligament ruptures, a warm-up warm-up should be done before training.
A high probability for injuries of the ankle ligaments exists in athletes involved in bodybuilding, weightlifting. With active movements, high jumps, there is a risk of ankle sprains. During lifting in a jerk of heavy weight, the load on the ankle leads to overload and rupture.
Injury manifests itself:
- pain syndrome
- swelling at the site of damage;
- bruising and bruising;
- tightness of movements
- problems with support.
In the event of an incomplete rupture, the symptoms are mild, you can rely on the limb. With a strong gap, the area of damage is characterized by edema, exciting part of the foot, bruising, freedom of movement is sharply limited. Reliance is practically impossible. When ligaments are stretched for 24 hours, a hot-water bottle with ice should be applied to the sore spot. On the 3rd day, dry heat is recommended, keeping the limb above body level. In case of injury to the left joint, the load is transferred when moving to a healthy leg, the use of crutches is recommended.
For medical treatment, you need to seek the appointment of a specialist.
Degrees of stretching
There are 3 degrees of severity of sprain:
- 1 degree – the fibers are partially torn, more than half of the entire connective tissue as a whole is not damaged. The victim has mild pain during movement and palpation of the joint. Ankle sprain is accompanied by tissue edema.
- In the 2nd degree, a significant part of the ligaments is injured and torn, there is swelling, parts of the joint are displaced. The patient feels severe pain, especially when moving. Swelling of the tissues while stretching the ligaments of the ankle captures the foot from the side of the sole. Lameness intensifies, palpation causes severe pain.
- Grade 3 is established with a complete break, the ligaments are torn off the bone, there is significant hyperemia (swelling), pain at rest. It is impossible to move and lean on a limb, swelling increases and reaches the fingers. Numerous hemorrhages and hematomas appear. Moving without a cane or crutch is difficult.
The treatment of the ankle depends on the severity of the joint damage. Experts recommend performing diagnostic tests of MRI to determine the amount of ruptured tissue. In x-rays, changes for the first two degrees of severity are not visible. With the 3rd, pieces of bone tissue are visible at the site of the torn ligament.
For all types, the symptoms of ankle sprain are similar, they are distinguished by the strength of the manifestation. In a patient with damage to the connective tissue when walking, pain, swelling and edema are observed during examination. For the second degree, the possibility of movement remains, there is a strong pain syndrome. Symptoms and treatment of the ankle are interconnected. With the injury itself, the patient sometimes hears a characteristic sound (crunch), this indicates a partial or complete break. Some athletes manage to feel a gap in the joint, in which reliance on the limb is painful. Large joint deformation indicates serious injury. Edema itself does not characterize the degree of damage. Its occurrence and intensity depend on the diameter of the injured vessels.
The following types of diagnostics will help establish sprains on the ankle or a complete rupture:
- stress test;
- X-ray (to exclude fractures);
- in complex cases of MRI.
Diagnosis is by clinical indications. The first is the determination of the number of whole ligaments. If swelling and pain are significant, do a radiography. In some cases, the signs of an ankle sprain in the first hours after the injury are difficult to determine (severe spasm and swelling). After two days, when the swelling decreases, a control examination is performed.
Complete separation of the ligaments is checked according to the scheme: the doctor holds the lower leg, with the other hand tries to move the foot. If there is a rupture of the anterior ligaments, the foot goes forward. The mobility of the foot to the side indicates a break in the lateral connections. The nature of the movement is compared with a healthy limb.
Important! Symptoms of injured ligaments of the ankle and fractures of the metatarsal bones of the foot are similar. Diagnosis should only be carried out by an experienced traumatologist.
You need to know what to do when stretching the ankle, to provide first aid to the victim. Let us dwell on the following rules:
- It is necessary to attach ice to the site of injury. This measure eliminates the spread of edema and reduces pain.
- In case of unbearable pain, it is recommended to take painkillers (aspirin, paracetamol, ibuprofen).
- The foot must be fixed in one position, slightly pulled by an elastic bandage.
- The patient should consult a traumatologist for further treatment.
Ankle sprains can be cured at home only after a physical examination and x-ray to prevent joint fracture. You need to be sure that the damage only affected the ligaments. We list further actions and limitations:
- You can not load the limb, edema after injury increases from 3 to 5 days and decreases within 3-4 days. About a week you need to spend at home.
- Fixation with an elastic bandage is necessary if there is a load on the injured limb. The amount of bandage is up to 3 layers. At rest, bandage is not necessary.
- To remove the swelling during sprain of the ankles, a package or a heating pad with ice wrapped in a towel is applied to the injury site. Cold compress time – 20 minutes 3-4 times a day. When the ankle is stretched, blood vessels are damaged, edema prevents the outflow of blood. All this inhibits the normal blood supply and nutrition of the limb.
- First aid for sprain – this is a special position of the leg: on a pillow or roller, the knee is slightly bent. Such measures help reduce swelling and restore blood flow.
- It is recommended to use gels, ointments with anesthetic effect with signs of ankle sprain. If there are cuts and abrasions, do not apply.
- For the treatment of ankle sprain at home, non-steroid pain medications are used. The pain can not be tolerated, swelling may increase.
The victim suffers significant consequences of the injury. Improper restoration of the ankle after stretching often leads to pathology of the lumbar spine. Violations develop gradually, after a few years. If the measures taken relieve swelling and pain, then this is not a guarantee of a complete cure. It is necessary to consult a doctor for qualified advice.
What can not be done
There are certain actions that are undesirable to perform in case of injuries of the ankle:
- You can not take warm baths and any thermal procedures (sauna, bath). Hot water provokes an increase in blood flow to the damaged area, this increases puffiness and causes an inflammatory process.
- Experts unanimously do not recommend exercise while walking and additional training. The joint and ligaments need a sparing regimen.
- To remove a tumor in the ankle does not help therapeutic massage. The injured joint does not need additional blood flow from the massage, new edema and hematomas may appear.
- Rupture of tendons in a joint requires compliance with movement restrictions for 2-3 days. Then gradually increase activity, which will help recovery.
In case of severe injuries, when severe pain prevents walking, you should consult your doctor. Restoration of the foot is possible subject to the recommendations.
How to apply a bandage
To provide a fixation dressing, certain skills are needed. In the correct position, the ankle joint is slightly bent. When applying an elastic bandage use the method of figure eight. Bandage the leg first above the joint (2-3 turns), then lower the bandage and gently fix the ankle in a circular motion. The bandage should cover the entire area of the joint, fixed with special braces in the shin area. The bandage holds the ligaments and muscle tissue, shortens the rehabilitation period.
To quickly cure sprain and restore joint function, before prescribing treatment, you need to make sure that there are no fractures or displacement of the bones of the injured joint. If there are suspicions of complications, an ultrasound examination and computed tomography (CT) scan are required. Treatment of ankle sprain after confirming the diagnosis:
- compliance with rest (bed rest) in the early days, ice compresses for 20-30 minutes during the day 4 times;
- to eliminate edema, the leg is bandaged from the lower leg to the tips of the fingers, it should be above body level, in complicated cases, a plaster cast for 14 days;
- the treatment of ligaments of the ankle joint can be accelerated by applying gels with anesthetic and anti-inflammatory effect (Ibuprofen, Fastum-gel);
- after the disappearance of puffiness and resorption of hematomas, salt warming, paraffin baths, ointments with a warming effect (Kapilar, Indovazin) are recommended.
The inclusion of sports supplements is recommended for additional intake of collagen, vitamins, and calcium. Treatment at home is possible with the recommendations of a specialist. Injury complicates training and causes a lot of inconvenience in everyday life. Drug therapy includes the use of NSAIDs (Ibuprofen, Diclofenac, Aspirin). Good results are shown in exercise therapy. Rotational foot movements, movements in both directions help to treat ankle sprains.
Ligaments by their nature are restored only when moving, it is recommended to do exercises at a convenient time:
- To improve blood supply at the ankle sprain, you need to bend and unbend your toes up to 30 times.
- Perform the same number of circular rotations in the joint.
- About 28 times it is necessary to rise and lower on socks.
- Toes on the support, heels in the air (use a bench or a strong board), lower the heels lower, repeat the exercise up to 55 times. This ensures an ankle stretch.
- Bare feet to hold small objects (balls, pens, erasers) with your toes.
All exercises must be performed under the supervision of a doctor to exclude complications of an injured joint.
The passage of therapeutic procedures in a medical institution will help accelerate rehabilitation during the recovery period:
- UHF (ultra high frequencies) – the use of alternating currents of high frequencies helps to stimulate patency of blood vessels. Activates tissue regeneration at the site of injury.
- Ultrasound – with micromassage, blood flow improves, metabolic processes normalize. The procedure has an analgesic and anti-inflammatory effect.
- Paraffin therapy – applications of heated material can be performed in the first few hours after stretching. As a result of therapy, pain, inflammation decreases, metabolism improves.
- Diadynamic therapy – the effect of currents of different frequencies anesthetizes the place of stretching.
- Magnetotherapy – improves blood circulation, relieves swelling.
- Water procedures – in the first week of classes you can perform exercise therapy in water. In the absence of pain and swelling, you need to start swimming lessons up to half an hour a day.
A diet with an increased content of protein and calcium will help restore an injured joint. Recommended drugs or dietary supplements with glucosamine and chondroitin complex for the treatment of ligaments.
Complications and prognosis
The complicated course of the injury is divided by the time of occurrence: at the onset of the disease and after the disappearance of the main symptoms. In the first case, the consequences are possible:
- dislocation or subluxation of the ankle, often encountered at 3 stages of injury;
- a large amount of blood accumulates inside the joint (hemarthrosis);
- purulent inflammation of the hematoma.
After 3 months, sometimes 4-5 years occurs:
- arthritis and arthrosis of the joint;
- flat feet with periodic ligament injuries;
- joint instability, frequent dislocations are possible.
With 1 degree of stretching, there are no consequences. If a degree 2, 3 of the ankle injury is established, pain develops over time with an increase in the load on the limbs. It is necessary to apply preventive measures in strength training (the use of special bandages). Training should be carried out in special shoes that fix the foot.
In case of ligament injuries, a favorable prognosis is due to the severity of the rupture, proper treatment and rehabilitation. With timely therapy, the damaged joint is restored in most cases.