ANKLE CONTUSION |
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General Information
DEFINITION--Bruising of skin and underlying tissues of the ankle due to a direct blow. Contusions cause bleeding from ruptured small capillaries that allow blood to infiltrate muscles, tendons or other soft tissue. Ankle contusions are common, but they are not serious injuries.
BODY PARTS INVOLVEDAnkle tissues, including blood vessels, muscles, tendons, nerves, covering to bone (periosteum) and connective tissue.
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SIGNS & SYMPTOMS
Local swelling--either superficial or deep.
Pain and tenderness over the bruise.
Feeling of firmness when pressure is exerted at the injury site.
Discoloration under the skin, beginning with redness and progressing to the characteristic "black and blue" bruise.
CAUSESDirect blow to the ankle, usually from a blunt object.
RISK INCREASES WITH
Violent contact sports such as field hockey, ice hockey and soccer, especially when ankles are not adequately protected.
Medical history of any bleeding disorder such as hemophilia.
Poor nutrition, including vitamin deficiency.
Use of anticoagulants or aspirin.
HOW TO PREVENTWear appropriate protective gear and equipment, such as high-ankle shoes, during competition or other athletic activity if there is risk of an ankle contusion.
WHAT TO EXPECT
APPROPRIATE HEALTH CARE
Doctor's care unless the contusion is quite small.
Self-care for minor contusions, and for serious contusions during rehabilitation.
Physical therapy for serious contusions.
DIAGNOSTIC MEASURES
Your own observation of symptoms.
Medical history and physical exam by a doctor for all except minor injuries.
X-rays of the injured area to assess total injury to soft tissue and to rule out the possibility of underlying fracture. The total extent of injury may not be apparent for 48 to 72 hours.
POSSIBLE COMPLICATIONS
Excessive bleeding leading to disability. Infiltrative-type bleeding can sometimes lead to calcification and impaired function of the injured muscle.
Infection if skin over the contusion is broken.
PROBABLE OUTCOMEHealing time varies with the extent of injury, but uncomplicated ankle contusions usually heal within 2 to 4 days.
HOW TO TREAT
NOTE -- Follow your doctor's instructions. These instructions are supplemental.
FIRST AIDUse instructions for R.I.C.E., the first letters of REST, ICE, COMPRESSION and ELEVATION. See Appendix 1 for details.
CONTINUING CARE
Wrap an elasticized bandage over a piece of sponge rubber on the injured area. Keep the area compressed for about 72 hours.
Continue ice massage. Fill a large Styrofoam cup with water and freeze. Tear a small amount of foam from the top so ice protrudes. Massage gently over the injured area in a circle about the size of a softball. Do this for 15 minutes at a time, 3 or 4 times a day, and before workouts or competition.
After 72 hours, apply heat instead of ice if it feels better. Use heat lamps, hot soaks, hot showers, heating pads, heat liniments or ointments, or whirlpool treatments.
Massage gently and often to provide comfort and decrease swelling. Stroke toward the heart from the toes.
MEDICATION
For minor discomfort, you may use:
Acetaminophen or ibuprofen.
Topical liniments and ointments.
Your doctor may prescribe stronger medicine for pain.
ACTIVITYAs soon as underlying damage can be ruled out, normal activity can begin within a day or two.
DIETFor serious injuries, eat a well-balanced diet that includes extra protein, such as meat, fish, poultry, cheese, milk and eggs. Your doctor may prescribe vitamin and mineral supplements to promote healing.
REHABILITATION
For serious contusions, begin daily rehabilitation exercises when supportive wrapping is no longer needed.
See section on rehabilitation exercises.
CALL YOUR DOCTOR IF
You have a contusion that doesn't improve in 1 or 2 days.
Skin is broken and signs of infection (drainage, increasing pain, fever, headache, muscle aches, dizziness or a general ill feeling) occur.
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