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Ankle Sprain:

Discussion in 'Ask your questions here' started by jmkamp06@smumn.edu, May 5, 2009.


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    Nearly two days ago, I suffered an ankle sprain. My Track and Field friends told me it's no big deal and it'll just take a little time to heal. I just checked online to see if this was true, and have found out that I've missed out on some imperative procedures to do in the following 48 hours of a sprain. I almost definitely have a 2nd or 3rd degree sprain, and I've been walking around on it (limping, really), haven't iced it, etc.

    My question is: Even though I've missed out on the proper ways to take care of it initially, should I treat it as if I just received the sprain, and follow the R.I.C.E. procedures as well as the stretches?

    Thanks
     
  2. FootDoc

    FootDoc New Member

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    First of all, a 2nd or 3rd sprain is a serious injury. So either your track and field friends are very poor diagnosticians or your assessment of your injury is way off. Whereas a Grade I sprain is a mere overstretching of the ligament(s), a Grade II is severe overstretching with some incomplete tearing of the fibrils of the ligament(s) and a Grade III is complete tear or avulsion of the ligament(s). I can pretty well predict that if one sustains a Grade II or III sprain, unless he/she has the pain tolerance of someone on PCP, one would not expected such an injured person to be walking around, even with a limp after 2 days. The standard initial first aid treatment of RICE is aimed at doing no further damage and relieving swelling. Unless your sprain were really a very mild one, it would generally be far too soon to be considering rehabilitative physical therapy. I think that your appropriate course of action is to now have a professional assessment of the damage by a specialist who deals with such problems . . a podiatrist or an orthopedist.

    Sprains, as I have mentioned above, are injuries to ligaments. Ligaments are elastic tissue bands which attach to and cross the adjacent bony structure(s) involved. Their function is that of a shock absorber and a retainer of joint integrity when outside forces cause non-physiologic/non-functional positions of the involved bones relative to each other. Unlike fractures of bone, which when adequately treated and when good healing takes place generally return the structure to "factory specs," with sprains where there is actual substantial tearing of the ligament tissue, although functional normality may occur, complete physiologic recovery from a histiologic aspect does not, as unlike bone which heals with bone tissue, ligament tears heal with fibrous scar, and the fibrous scar does not have the elastic capacity necessary for proper ligament function. Therefore, even after healing of ligament tears, the ligament is not capable of the same degree of function as it was prior to the tear. As I pointed out, this may not noticeably impair gross function, especially if adequate care is timely administered and rehabilitation is successful, but on the other hand, it may alternately result in life-long deficit, joint instability and the increasing possibility of future sprains due to that instability. If that then becomes a significant problem, other sorts of surgery to mitigate the lack of innate ligament function may be necessary.

    All this may be and probably is far more severe of an outcome than you might expect. But I would strongly advise professional evaluation NOW in order that you might have the best chance of the most pleasant outcome possible. Sprains are often not the simple injuries which most folks think and time spent now in proper treatment may pay big dividends for the rest of your life.
     
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