Don’t take a sprained ankle lightly!

Reading thousands of books, traveling thousands of miles, and measuring the world with your feet; reading thousands of books, traveling thousands of miles, and being confined to a small space by spraining your ankle? Spraining your ankle, also known as ankle sprain, is one of the most common musculoskeletal injuries. According to statistics, there are about 2 million cases of acute ankle sprains in the United States each year, with an incidence rate of 2 to 7 cases per 1,000 person-years. Its incidence rate in high school and college sports is as high as 15%.

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Today, let's talk about why we sprain our ankles. Are there only 0 or countless sprains as rumored? What harm will it cause if we ignore sprains? How to deal with it after it occurs? And how to prevent it from happening?

#1

Causes of sprained ankle

If you want to do your work well, you must first sharpen your tools. If you want to understand what a sprained ankle is and how it happens, you first need to understand the composition of the ankle.

The ankle joint is mainly composed of the tibia, distal fibula and talus of the lower limb. The anterior and posterior walls of the ankle joint capsule are weak and loose to fully exert its movement potential. At this time, the ligaments connecting the bones, the coordinated bones, and the joint capsule "three brothers" play an important role in static stability. In the process of their work with the muscles, if the center of gravity shifts or the ankle joint is violent at high speed, the load range that the ligament can withstand may be broken, further causing relaxation or tearing. In this process, inversion plantar flexion sprain is the most common. Its high incidence is related to weak ligaments, the end of the fibula is lower than the tibia, large inversion range of motion, and some kinematic factors.

#2

Recurrence of sprained ankle

It is said online that there are only 0 and N times of spraining an ankle. Although there is no literature to prove that a sprained ankle will definitely happen again, nearly one-third of patients will experience repeated sprains, accounting for 12% to 47% of the total incidence of sprains. Other studies have shown that the risk of re-spraining is about 3.5 times higher for patients with a history of ankle sprains than for those without a history of ankle sprains. A domestic data shows that 73.5% of people who sprain their ankle have sprained the same ankle at least twice, and 22% of people who sprain their ankle have experienced repeated sprains of their ankle 5 or more times in the past.

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The high recurrence rate is closely related to chronic ankle instability after sprain. The chronic ankle instability mentioned here can be understood as a comprehensive state of local joint pain, poor control, and reduced sensory ability caused by chronic dysfunction of the lateral ligament complex of the joint. This state and ankle sprain can be said to be mutually causal. Up to 70% of patients with acute lateral ankle sprains may develop chronic ankle instability within a short period of time after the initial injury.

#3

The dangers of sprained ankle

As mentioned above, ankle sprains often lead to chronic ankle instability, which can further lead to repeated ankle injuries and subsequent joint adhesions. In severe cases, the most worrying post-traumatic osteoarthritis may occur, which is the degeneration, hyperplasia, and ossification of the articular cartilage.

Lateral ankle sprains account for 13% to 22% of all cases of osteoarthritis involving the ankle and 80% of cases of osteoarthritis caused by trauma. A small number of ankle sprains can cause damage to the common peroneal nerve and abnormal gait when walking, which are easily overlooked.

#4

Treatment of sprained ankle

The mainstream view in the past was to reduce bleeding and exudation, relieve joint swelling and pain, and avoid further damage. Therefore, the PRICE treatment plan was recommended, which includes P-Protection, R-Rest, I-Ice, C-Compression, and E-Elevation. That is, after the injury, local compression and ice compress are used to stop bleeding and reduce swelling, and then plaster, bandages, braces, etc. are used to fix and protect the affected limb, and the limb is elevated for further bed rest. Although some literature points out that the scientificity and efficacy of this method need to be verified, it is sufficient for the treatment of common sprains.

Combined with some of the latest research, functional treatment is more recommended, that is, using an ankle brace as an external support for 4 to 6 weeks after injury. During this period, auxiliary neuromuscular proprioception training can not only effectively treat ankle injuries, but also shorten the time to return to normal activities and reduce the occurrence of ankle instability. When the pain is severe, non-steroidal anti-inflammatory drugs (such as piroxicam, celecoxib, naproxen) can be used to relieve pain, swelling and promote recovery. In addition, there is surgery. I believe everyone will be surprised when they see this: "What! A sprain requires surgery?" Yes, surgery is indeed effective for joint sprains, but there is no uniform standard. The current surgery is mainly aimed at patients with chronic ankle instability after ankle sprains, combined with talofibular ligament injuries, deltoid ligament injuries, and athletes who do not respond to comprehensive conservative plans or are eager to return to the playground and have high functional needs.

#5

Prevention of sprains

Ankle sprains are prone to recurrence and bring chronic adverse consequences. In addition to emergency treatment, prevention is also particularly important. Studies have shown that strengthening lower limb musculoskeletal training and enhancing the body's balance and proprioception are significantly beneficial for preventing ankle and other lower limb musculoskeletal injuries. These trainings include: sitting and standing exercise therapy, visual feedback training, equipment-assisted training, soft tissue stretching, and muscle strength training.

Image source: Pixabay

In addition, the ankle braces that we often see athletes using can also play a protective role. Other scholars have pointed out that reducing muscle fatigue can greatly reduce the occurrence of ankle sprains. Looking back, this is an era of stumbling. We should pay attention to the road under our feet and learn to adjust our bodies. The all-round care of exercise, protective gear, and rest can make you worth running, jumping, and traveling thousands of miles!

Source: Chongqing Science and Technology Museum

Author: Wei Yi, Ph.D. from Chongqing Medical University and one of the top ten science popularization ambassadors in the country.

Review experts: Huang He, Li Chunli, Chen Tao, Xu Xiaoping

Statement: Except for original content and special notes, some pictures are from the Internet. They are not for commercial purposes and are only used as popular science materials. The copyright belongs to the original authors. If there is any infringement, please contact us to delete them.