Information on Ankle Injuries
There are several types of ankle injuries, some serious enough to require many months of healing and others that can heal within a few weeks.
Types of Ankle Injuries
- Ankle Sprain: Caused by stretching or tearing of one or more ligaments (structures that connect bones to bones). Most sprains result from accidental turning of the foot inward.
- Tendonitis: An inflammation of a tendon caused by overuse. Tendons connect muscles to bones.
- Fractures: Ankle injuries can sometimes result in fractures of the bones comprising the ankle joint. Many of these fractures can be treated without casting.
- Stress fractures: Develop over time as a result of overuse of the ankle.
Severity of Ankle Sprains
- First Degree: Ligaments connecting the bones of the ankle are stretched but not torn, with little swelling and no instability. You can expect to be back to sports within a couple of weeks.
- Second Degree: Ankle ligaments are partially torn and the ankle usually swells quickly. This sprain may require three to six weeks to return to full activity. There is mild instability, and pain is often present with walking and bearing weight.
- Third Degree: This is a more serious tear of ligaments and requires six to twelve months to fully heal. There is often severe pain, swelling, and bruising.
Treatments for Ankle Injuries
- Physical Therapy (PT): Contact your health care provider for a referral to Physical Therapy at UHS. In PT you will learn advanced strengthening exercises to enable your return to higher-level activities and to lessen the chance of re-injury.
- Rest: Reduce activity on your ankle and build up stress on your leg slowly and easily. Avoid uneven ground. Don’t run until you can walk without pain. Don’t take part in activities requiring sudden movements and turns until you can run without pain.
- Ice: Use ice (in a plastic bag, ice bag or cold pack) for 15 to 20 minutes every 1 to 2 hours during the first 48 hours after your injury. You should place a thin layer of fabric, such as a pillowcase, between the ice bag and your skin. After 48 hours, continue to ice 2 to 4 times a day for pain and swelling.
- Compression: An elastic bandage helps to keep the swelling down. Keep it on the injured area as long as there is swelling but remove it at night.
- Elevation: Elevate the joint as much as possible to control swelling. Optimal elevation would be to elevate the injured area above the level of the heart.
- Medication: Ibuprofen (such as Motrin or Advil) or Naproxen (such as Aleve) can be used to decrease pain and inflammation. Acetaminophen (such as Tylenol) can be taken for pain relief but does not decrease the inflammation. Follow the directions on the bottle. If you experience stomach upset, discontinue use and contact your health care provider.
- Protection: A functional brace is recommended for walking initially after an ankle sprain, to protect the injured ligament. The brace may also be needed when initially returning to sports.
- Crutches: Crutches may be recommended until you can walk on the ankle with a fairly normal heel-to-toe gait.
Exercises and Physical Therapy
- Range of Motion: On the day after your injury, begin moving your ankle straight up and down ten times an hour. As soon as the ankle starts to feel better, switch to an exercise where you draw the alphabet, one letter at a time, with your big toe. Repeat every hour. These exercises will help decrease swelling and prevent stiffness.
- Stretching: Lean forward against the wall with both hands, keeping your knees straight and your heels on the floor. Lean forward until you feel a stretch (but not pain) in your calf muscles. Hold for about 20 seconds without bouncing. Repeat with your knees slightly bent (you’ll feel this stretch in your Achilles tendon.) Do each stretch 3 to 5 times. Try to do 2 to 3 sessions of stretching each day.
- Isometrics: With the outside of your foot against the leg of a table, gently push against the table leg and hold for 6 seconds. Repeat 5 to 10 times. Then position the inside of your foot against the table leg and repeat 5 to 10 times that way. Lastly, with your foot under a couch or other fixed surface, gently push the top of your foot up against the surface and hold for 6 seconds. Repeat 5 to 10 times. If you have pain with these exercises, decrease the force with which you are pushing.
- Heel Raises: Stand on both feet, holding onto a desk or other fixed object for balance. Raise your heels from the floor and then slowly lower. Go as high as you can without pain. Try to do 2 or 3 sets of 10 repetitions.
- Balance: Stand and balance on injured leg for 10 to 15 seconds. Gradually try to increase your time up to 1 to 2 minutes.
In an emergency go to Mount Nittany Medical Center or call 911 for an ambulance.
This content is reviewed periodically and is subject to change as new health information becomes available. This information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Approved by the UHS Patient Education Committee Revised 07/16/19