03/28/2008 02:47 am ET Updated Nov 17, 2011

Ankles In Agony

There is no such thing as a simple ankle sprain!! Doctors are seeing more frequently patients who incurred "simple" ankle injuries in the past now complaining of ankle instability, arthritis and pain. Ankle sprains are considered to be the most common orthopedic injury with an estimated 2 million people per year seeking treatment. Baby Boomers who start to exercise again are presenting with greater frequency with ankle pain that may have been caused by injuries that happened years ago that were never treated initially and therefore never healed properly in the first place. Arthritis in the ankle and chronic soft tissue injuries are often the result of inadequate to no treatment in the first place.

There are four types of injuries that may occur after a sudden ankle twist. Sports medicine doctors often classify athletic ankle injuries using the following descriptions:

1) Strain: involves a muscle, ligament or tendon becoming overstretched.

2) Sprain: this is more severe in nature. The ligaments that attach one bone to another may be partially or completely torn.

3) Tear: the great force generated by the body twisting can rip the tendons in the foot.

4) Fracture: bones in the foot and ankle can be broken from the force generated from the twisting ankle.

Patients who have ankle injuries should not self-diagnose. When your ankle becomes swollen, hot, tender to the touch, discolored, and painful on weight-bearing may signify trauma to the soft tissues (tendons, ligaments, muscles)and bones of the ankle and foot. Patients should visit their foot health professional such as a podiatrist or orthopedist. Don't wait and self treat when these symptoms are present as they may indicate a more serious ankle injury that requires prompt medical evaluation and treatment.

X-rays should be definitely be taken to rule out a fracture and or dislocation of a joint, diagnostic ultrasound or MRI to rule out soft tissue injury such as tendon, ligament, or muscle damage.

Treatments for the injured limb may include immobilizing the ankle and using compression devices such as a walking cast and or air cast to reduce swelling and immobilize preventing further damage and injury. Physical therapy may be recommended to strengthen the foot and ankle as well as decrease pain, swelling, and inflammation. It may take up to one year for an ankle injury to sufficiently heal. Patients should be warned there may be residual weakness in the severely sprained ankle. They will also be more inclined to re-injure the ankle on future occasions.

Some patients may require the use of a prescription orthotic prescribed by a podiatrist. These devices help stabilize the ankle and prevent excessive abnormal motion in the lower extremity. In addition, a prescription orthotic helps the foot and ankle to function more effectively as shock absorbers for the entire body while decreasing abnormal forces that are produced when a person walks or runs. These devices have become a part of the standard treatment protocols when treating elite and professional athletes. A recent study showed the efficacy of orthotics in preventing sports injuries as well.

In more severe cases patients may require surgical intervention to repair tendons and ligaments. Most ankle sprains, however, are treated very effectively with conservative intervention. The more ominous problem is denial by a patient that there is injury to the ankle further delaying professional evaluation and treatment. All too often a patient will present to the doctor five years after twisting their ankle only to find the presence of advanced arthritis and soft tissue scarring and damage. Nothing can ruin a jog in the park, a weekly tennis game, or a round of golf than a painful ankle. All too often the person will lament "I thought it was only a simple ankle sprain".