Ankle sprain in a young female with history of previous injury of ankle ligament

Patient

Q: Hi, on saturday i tripped over and badly hurt my foot, i already have permenant ligament damage in the foot. i went to see a doctor today and they said i have pulled the surface ligaments. I can't really walk with the painful foot and there is a large amount of brusing around my big toe area and down that bone. So i was wondering if i could have a second opinion?

Doctor

A:   From all the ankle injuries, the sprains are the most common. Ankle sprains are classified in 3 grades as follows: : mild degree of swelling and stretch has occurred to the ligaments. Weight bearing is possible. : moderate swelling and an incomplete tearing of ligaments, also mild instability may be present and also pain with weight bearing. : severe swelling and pain, complete rupture of at least 1 ligament, there is remarkable instability. If you are experiencing limitation to walking, severe pain and swelling and/or deformity, I strongly recommend you to go to the emergency department and get a doctor’s evaluation and x-rays to rule out a fracture. If it is an Ankle sprain without fracture the treatment strategy is as follows: First thing to do is applying ice and lift the affected limb for the first 24 hours, to control the pain and swelling. Physical therapy is recommended for sprains grade II and III with protected ambulation, and exercises to get back the normal range of motion and strengthening of the ankle muscles and ligaments. Treatment during this acute phase is aimed to minimize swelling and pain, allowing you to begin walking asap. The acute phase of treatment should last for 1-3 days after the injury, the 4 to 6 weeks after that you should have a combination of protection, relative rest, ice, compression, elevation, and support. Also you can take the anti inflammatory medication (as “motrin”, “aleve”) those help in reducing swelling and pain. The healing time is different for each patient, and also depends on the severity of the initial injury.

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