Part 3: Ice it or ER? Ankles by Tufts MC

Part 3: Ice it or ER? Ankles by Tufts MC

tufts medical center logo

Ankle pain and injuries are common. Whether you’ve tripped while walking, missed a curb, or landed the wrong way, undoubtedly you’ve experienced a twinge of pain here or there. But what about the times when your ankle pain is more serious than that?

Causes

Most ankle problems that bring young people to the doctor are the result of traumatic events.  The most widespread type of ankle drleviankleinjury is what is called an inversion injury. This is when the foot or ankle turns inward unexpectedly.

Typically, these “twists” will result in an ankle sprain. Less common traumatic injuries include ankle fractures, Achilles tendon ruptures, or peroneal tendon dislocations (the dislocation of the tendon that runs behind the bony part of the outer ankle).

Although ankle injuries are typically from sudden traumatic incidents, overuse injuries can still occur! If you’re a runner who increased your mileage too quickly, needs some technique adjustment or more supportive running shoes, you might be susceptible to overuse injuries.

Symptoms

When you injure your ankle, expect to see a lot of swelling, pain, bruising and/or difficulty bearing weight on the ankle. You’ll often see all of these symptoms much more in the ankle than in the knee or shoulder.

Preventing Ankle Injuries

While you can never prevent all injuries, you CAN work to decrease their likelihood and severity through exercise and keeping the muscles around the ankles strong.  The muscles in the ankle are very small, and strengthening them is beneficial. One additional factor that may make you more susceptible to ankle injuries is a lack of proprioception, or your body’s understanding of where your ankle (or other body part) is in space.

How do you gain proprioception? Try ankle coordination exercises such as standing on one leg, standing on a Bosu ball, or doing one legged squats. You can work with a physical therapist, trainer, or on your own.

Have more questions? Dr. Matt Salzler, Orthopaedic Surgeon at Tufts Medical Center, has your answers! Read below for common SBS inquiries!


What is the difference between an ankle break and an ankle sprain?

An ankle break, or fracture, occurs when a bone is, well, broken! It becomes cracked and a once solid bone is in two pieces that don’t touch anymore.

An ankle sprain is a torn ligament.  A ligament is a band like tissue that connects two bones together. These ligament injuries come in different grades that take varying amounts of time to heal. A grade 1 sprain is a stretched ligament, a grade 2 sprain is a partial ligament tear, and a grade 3 sprain is a complete tear of the ligament.

Typically, ankle sprains occur in the low ankle – on the lower, outer part of the ankle with pain moving down the foot. High ankle sprains are less common (though you hear about them more often in NBA or NFL players) and then the injury goes up the ankle and leg instead of down the foot. These are often more painful injuries that require closer follow-up and take longer to heal.

Can doctors at Tufts Medical Center treat a sprained ankle, or should I just ice it?

Yes, doctors can treat a sprained ankle.  The treatment depends on the injury. Low ankle sprains can be treated symptomatically with RICE (Rest, Ice, Compression, and Elevation) a brace, and physical therapy. But the primary reason to see a doctor is to determine if you actually do have a low ankle sprain versus high ankle sprain, an ankle fracture, or another injury requiring different treatment.

What are some exercises that I can do to strengthen my ankle and decrease the chance of injury?

One easy exercise is to write the alphabet with your ankle. This works the same muscles as other exercises, and is easy to do wherever you are!

For other proprioceptive exercises, try the ones in this video.

I hurt my ankle playing sports 2 weeks ago and it is still sore.  However, I can walk on it. I have been icing it every day. Should I see a doctor or keep doing what I’ve been doing?

If your ankle is continuing to improve, you haven’t rolled it again, and there is no clicking, popping or deformity, then it’s often okay to give it a little time. If you aren’t completely better with two weeks, then see a doctor. However, don’t hesitate to err on the side of caution is you have concerns – seeing a doctor before then won’t be a bad call.

Is it okay to continue playing sports with an ankle injury?

It depends on what the injury is. In general, if you’ve been seen by a physician, have full range of motion and full strength, then it is usually okay.

I was playing in a softball league when I turned a base and my ankle started to throb. There’s a bump on my ankle but it isn’t bad. I have been icing it for days and although it is still sore, I can walk on it. Should I continue icing it or should I see a doctor at Tufts MC?

I would give the same response as the question about hurting your ankle 2 weeks ago and it still being sore. If you’re concerned, see a doctor at any time to rule out or confirm an injury.  If you’re noticing improvement, you can give it a c4c1a24c0d8c7b60fbdf416aa7ba4f06little time to see if the problem resolves itself, and see a doctor if it doesn’t.

In general, when do I need to see a doctor or have an x-ray?

It is more difficult to specifically give a threshold for a doctor’s visit for an ankle injury than a knee injury.  I would err on the side of caution. If you can’t walk on it, you have pain when you push on the bones around your ankle, if the pain goes up your leg around your ankle or if there is some deformity, or if you have any other concerns, seek treatment.


Do you have any questions or other parts of the body you’d like to ask questions to Tufts MC about? Tweet@socialboston or @tuftsmedicalctr and let us know!

The content provided in this post is intended solely for the information of the reader. This information is not medical advice and should not replace a consultation with a medical professional. Please call 617-545-5352 to make an appointment with a physician if you’d like more information.

Contact Us

sports@socialbostonsports.com

(617)-987-0602

119 Braintree Street

Boston, MA 02134