Lots of men worry about their back going out—or their knees just going. The lowly ankle sprain, however, is viewed as the common cold of musculoskeletal injuries. It happens, and you get over it. It's hard to avoid. But a growing number of researchers, surgeons, and trainers believe it's time to rethink this joint.
A sprained ankle is the most common injury in sports, and yet our understanding of it is only now coming into focus. Sprains cause more damage than we once thought they did, and we can do a lot more to prevent the fallout. In short, "Walk it off" may not be the proper response. Every day, 25,000 Americans turn an ankle: That's 9 million sprains a year. A recent study using data from NBA team doctors and trainers found that ankle sprains are the most common injury among pro basketball players, on and off the court. That's why international conferences are devoted to the joint.
Jay Hertel, Ph.D., A.T.C., FACSM, who studies ankles at the University of Virginia, says that until recently, sprains were considered largely benign after the initial pain and swelling went away. But opinions have changed: Inadequate treatment could prime you for years of residual pain and resprains, he says. Some 30 percent of sprain victims face chronic ankle instability. In one study, 34 percent of people who sprained an ankle went on to sprain it again in the following 3 years.
Exercise should fight off pain, not cause it. Adjust your approach with these six ways to injury-proof your workout.The ligaments in your ankle, Hertel says, are laced with sensory receptors. "These are responsible for telling the brain where the ankle is in space," he says. When a sprain occurs, some of these sensors are permanently damaged; as a result, your ankle can't communicate as well with your brain.
That's where rehab comes in. "If you stop treating an injured ankle as soon as the symptoms go away, you will have problems down the line," Hertel says. Rehab, when approached correctly, can help you regain a kind of ankle virginity—that is, if you remain sprain-free for a year, your risk returns to what it was before your mishap. The secret to reclaiming your ankle's V-card lies in the four steps below.
Assess
Beneath that bloated purple mass are three groups of ligaments that hold (or used to hold) the joint in place. They can stretch and loosen (a grade I sprain), stretch and partially tear (grade II), or tear completely (grade III). In the "high ankle sprain" of NFL injury reports, the large ligaments connecting your ankle to your two lower-leg bones are also damaged.Your immediate diagnosis is simple: "There's mild or severe. You can either walk or you can't," says John Kennedy, M.D., an orthopedic surgeon at the Hospital for Special Surgery in New York City. If you aren't able to bear weight on your foot, seek immediate medical attention so a doctor can further diagnose the severity of your sprain. Otherwise, proceed to the next step.
Rest
And add to this "ice," "compression," and "elevation" for the textbook RICE treatment, which everyone knows about—and nearly everyone screws up.
Once at rest, wrap a compression bandage comfortably around the foot and ankle to minimize swelling. When an ankle is swollen, "the fibers in the ligaments are pushed in different directions, and they may not heal in their natural anatomic position," says orthopedic surgeon Mark Drakos, M.D., the lead author of the NBA injury study.