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Dear Dr. Caraotta,
Our son is playing basketball again and sprained his ankle. The trainer said that this is only a slight sprain. He was told to put ice on it and keep his foot raised up on a chair to help get the swelling down. Last year he sprained his ankle three times and one time he had to miss three games in a roe. Why does this keep happening? Is it the type of shoes he is wearing, or does he just have weak ankles?
Dr. Caraotta's Response
Ankle sprains are very common in certain sports. The most common type of ankle sprain is what we call an inversion sprain. This is when the ankle is turned inward and stretches the ligaments on the outside of the ankle. When this occurs, the way it is managed is crucially important, to insure that the problem is not recurrent. What the trainer advised is very appropriate in your sons case.
When a person sprains an ankle the immediate care should be to:
P - Protect it.
R - Rest.
I - Ice.
C - Apply a compression wrap.
E - Elevate it.
The acronym "PRICE" is an easy way to remember this. Depending on the severity of the sprain, taking an x-ray may be in order, since it is not uncommon to break an ankle and mistake this as a sprain.
In our office, to speed up the healing process, we commonly incorporate ultrasound and/or electrical muscle stimulation to increase circulation, decrease swelling and accelerate the healing process.
When the swelling goes down, joint manipulation of the Tibial-Tailor joint is very important. Tibial-tailor joint mobility is crucial for proper flexion, supination and extension of the ankle.
When this joint has a fixation in it, often times a person does not experience any ankle or foot pain, but is susceptible to recurrent ankle sprains. This may be the case with your son.
Another important factor to prevent recurrent ankle sprains is to make sure the supportive ligaments around the ankle are strengthened. There are several appropriate “closed chain” exercises that could facilitate this. Most of the time, a patient is able to perform these at home.