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Don't Call It 'Just A Sprain'

If you treat an ankle sprain lightly, it may come back to haunt you

MONDAY, May 28, 2001 (HealthDayNews) -- You could call an ankle sprain the Rodney Dangerfield of injuries. It simply gets no respect, forever referred to as "just a sprain" and regarded as the far-less impressive alternative to the ankle fracture.

But experts say it would be wiser to think of an ankle sprain as Glenn Close's obsessed character in "Fatal Attraction" -- ignore it and you'll pay a hefty price, and don't assume it'll just go away on its own.

"The most common reason for an ankle sprain is having had one already," says San Francisco orthopedic surgeon Dr. Glenn B. Pfeffer. "And the best prevention of a second sprain is appropriate treatment of the first."

Sprains occur when the ligaments on the outside of the ankle either stretch or rupture when the foot falls inward and the weight of the body falls on the ankle.

The initial sprain can cause such problems as cartilage injury, associated fracture of the ankle, tendon problems or a loose ankle.

And sprains that aren't adequately rehabilitated can leave ligaments weakened, causing diminished strength and balance that often lead to more sprains.

"People can lose a very subtle sense of balance on the injured ankle," says Pfeffer. "In addition, they can develop Achilles-tendon tightness, and that's actually one of the most common reasons that people have recurrent ankle sprains."

The good news is that "appropriate treatment" -- which ideally would include seeing a specialist and a personal trainer -- can also be accomplished through a few treatment measures at home.

Those measures include the use of a simple ankle brace to provide support, along with items that can be purchased at any drug store, like ice packs or elastic wraps.

Dr. Carol Frey, an orthopedic surgeon in Manhattan Beach, Calif., says it's also important to take a proactive approach to therapeutically rehabilitating a sprained ankle.

"One of the most common mistakes people make is to not strengthen the leg or ankle -- especially the tendons on the outside of the leg/ankle that give you stability and stop you from rolling the ankle."

"Also, balance needs to be retrained as the nerves that promote balance are injured with an ankle sprain and need to be retrained or you will injure yourself again."

Among the most common sprains are those sustained by kids and teens, particularly high school athletes. Such sprains are often also the slowest to heal because the athletes won't give them enough time to heal. And that can sometimes result in chronic ankle pain.

"A big problem is the simple exuberance of youth," says Pfeffer. "Young athletes will become active again well before their sprain has healed."

Many will return to their sport or activity after simply having had their ankle taped -- commonly believed to offer protection.

But an ongoing study by Frey of 450 high school athletes shows so far that athletes are much better off using prefabricated ankle bracing rather than taping their ankles -- whether it's to heal a sprain, or prevent one in the first place.

"The incidence of ankle sprains is less in the braced group," he says, "and if they do have a sprain, the severity is less."

Pfeffer says, however, he regularly sees evidence that few follow the experts' advice on caring for sprains.

"Every day I'll see someone who says, 'I sprained my ankle. I was relieved it wasn't a fracture and I just expected the pain to get better, but it never did.' "

What To Do

For lots of information on treating and rehabilitating a sprained ankle, visit the American Academy of Orthopaedic Surgeons.

Or visit the American Orthopaedic Foot and Ankle Society for a list of Ten Steps to Fit Feet.

And read more about ankle sprains in these HealthDay stories.

SOURCES: Interviews with Glenn B. Pfeffer, M.D., orthopedic surgeon, San Francisco, Calif.; Carol Frey, M.D., orthopedic surgeon, Manhattan Beach, Calif.; American Academy of Orthopaedic Surgeons press release
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