DESCRIPTIONA mild ankle sprain involves stretching and slight or partial tearing of one or more ligaments in the ankle. The ligaments that support the ankle joint; the three main bones of the ankle joint; and the blood vessels, nerves, periosteum (covering of the bone), and other soft tissue close to the injury are involved. Appropriate health care includes: doctor's care only if discomfort is great or doesn't improve in 24 hours; self-care after diagnosis; whirlpool, ultrasound, or massage.
SIGNS & SYMPTOMSAnkle pain at the time of injury.
A feeling of popping or tearing in the outer part of the ankle.
Mild tenderness at the injury site.
Little loss of function. The injured child can bear weight and walk without help for 30 minutes or so following injury. Then, depending on the extent of injury, the joint may seem to lose some of its stability.
Swelling in the child's ankle.
Little or no visible bruising for several hours after injury. Then some bruising may appear.
Stress imposed from either side of the ankle joint, temporarily forcing or prying the ankle or heel bone out of its normal socket. The ligaments that normally hold the joint in place are stretched and sometimes torn.
RISK FACTORSPrevious ankle injury or any sport in which sideways displacement of the ankle is likely. Runners, walkers, and participants in such sports as basketball, soccer, volleyball, skiing, distance jumping and high jumping are prone to ankle sprains. When jumping, they often accidentally land on the side of the foot.
Poor muscle strength or conditioning and walking or running on rough surfaces, such as roads with potholes.
Poorly fitting shoes or footwear.
PREVENTING COMPLICATIONS OR RECURRENCEInstructions for your child:
Build your strength or conditioning; warm up before practice or competition; tape the ankle from midfoot to midcalf before practice or competition. If you cannot use tape, wrap the ankle with elastic bandages or use an elastic brace; wear proper protective shoes. Provide your ankle with substantial support during sports activities for 12 months following any significant ankle injury.
MEDICAL TESTSX-rays of the child's ankle, foot, and knee to rule out fractures.
POSSIBLE COMPLICATIONSProlonged healing time if the child resumes activity too soon; proneness to repeated injury; unstable or arthritic ankle joint following repeated injury.
The full extent of the child's injury cannot be determined for 12 to 24 hours. A mild ankle sprain usually heals enough in 5 to 7 days to allow modified activity. Complete healing requires an average of 6 weeks.
FIRST AIDThe goal is to prevent further injury to the child's torn ligaments. Follow instructions for R.I.C.E., the first letters of rest, ice, compression, and elevation. See Appendix 39 for details.
Continue using an ice pack on the child's ankle 3 or 4 times a day. Wrap ice chips or cubes in a plastic bag. Wrap the bag in a moist towel, and place it over the injured area. Use for 20 minutes at a time.
Provide the child with whirlpool treatments or time in a spa, if available.
Keep the child's foot elevated whenever possible to decrease swelling.
Massage the child's ankle gently and often to provide comfort and decrease swelling.
MEDICATIONFor minor discomfort use non-prescription medicines such as aspirin, acetaminophen, or ibuprofen.
Your doctor may prescribe an injection of procaine and hyaluronidase to decrease pain soon after injury or stronger medicine for pain, if needed.
Except for very minor injuries, your child should walk with crutches for about 72 hours, then resume normal activities gradually.
DIET & FLUIDS
During recovery, your child should eat a well-balanced diet.
OK TO GO TO SCHOOL?Yes, when condition and sense of well-being will allow.
CALL YOUR DOCTOR IF
Your child has symptoms of an ankle sprain that does not improve within 1 week or ankle pain, swelling, or bruising increase despite treatment.