The most commonly sprained or strained joint is the ankle. Approximately 1 million ankle injuries occur each year, and 85 percent of them are sprains. Ankle sprains can occur during competitive sports or during routine daily activities (walking).
The three ligaments frequently involved in ankle sprains include
anterior talofibular ligament
posterior talofibular ligament
The length of recovery for an ankle sprain can be as long as a fracture (6-10
weeks), and it is important for an athlete to wait for healing and rehabilitation
to be complete prior to returning to his/her sport. An ankle rehab program
is usually done with a physical therapist who will guide the patient back
into sports and activities. Completing a formal ankle rehabilitation program
will often help avoid re-injuring the ankle.
It is important to note that because children have open growth plates (epiphyses), it is often difficult to differentiate between an ankle sprain and a growth plate fracture. The growth plate appears as a black line on an x-ray which makes it difficult to see a fracture line (which is also a dark line). If there is tenderness directly over the bone where the growth plate is located, then the injury will be treated as a fracture which usually involves a short leg cast for 4-6 weeks.
|Ice - Place a plastic bag with ice on the ankle for 15-20 minutes, 3-5 times/day for the first 24-72 hours. Leave ice off at least 1 1/2 hours between applications.||Compression - Wrap an elastic bandage from the toes up to midcalf, using even pressure. Wear until swelling decreases. Loosen the wrap if toes start to turn blue or feel cold.|
To Restore Normal Ankle Function:
Range of Motion Exercises
Flexibility (Stretching) Exercises
Loosen tight leg muscles. Tightness makes it hard to use stairs, walk, run and jump.
Technique: Hold each exercise 15 seconds at a gentle stretch. DO NOT BOUNCE!
Frequency: 15-20 reps/exercise, 5-7 days/week
Strengthening Exercises: Thera-Band exercises-resisted inversion, eversion, dorsiflexsion, plantarflexion
Depending on the severity of the injury, other treatments may include:
Activity Restrictions: avoid re-injury to ankle, need to complete functional testing pain free prior to return to sports [jogging forward/backward, figure eights, one foot hops, etc]
Splint/Cast: protects the ankle to prevent re-injury while ligaments
Crutches/Wheelchair: crutches are needed until patient is able to
bear weight without pain
Physical Therapy: (to stretch and strengthen the injured muscles,
ligaments, and tendons): very important to complete ankle rehabilitation program
prior to return to sports to avoid re-injuring the ankle
Surgery: (recurrent instability, or if a muscle, tendon, or ligament is badly torn)
Content Created 7/2003: Jospeh Farrell: Pediatric Orthopaedic Student Intern
Erin S. Hart, RN, MS, CPNP: Pediatric Nurse Practitioner