A sprained ankle—also known as an ankle sprain, rolled ankle, ankle injury or ankle ligament injury—is a common medical condition where one or more of the ligaments of the ankle is torn or partially torn. The anterior talofibular ligament is one of the most commonly involved ligaments. Sprains to the lateral aspect of the ankle account for 85% of ankle sprains. In medical parlance, swelling is the enlargement of organs caused by accumulation of excess fluid in tissues, called edema. It can occur throughout the body (generalized), or a specific part or organ can be affected (localized).
Swelling is considered one of the five characteristics of inflammation; along with pain, heat, redness and loss of function. In a general sense, the suffix “-megaly” is used to indicate a growth, as in hepatomegaly, acromegaly and splenomegaly. A body part may swell in response to injury, infection, or disease, as well as because of an underlying lump. Swelling — especially swelling of the ankle—can also occur if the body is not circulating fluid well. Generalized swelling, or massive edema (also called anasarca), is a common sign in severely ill people. Although slight edema may be difficult to detect to the untrained eye, especially in an overweight person, massive edema is very obvious.
Treatment of Swollen Ankles
- Get a Podiatrist or Orthopedic Doctor: Severe ankle sprains should be assessed by a podiatrist or an orthopedic doctor, although physical therapy treatment is extremely effective for most sprained ankles. Immediately following the injury, it is important the follow the PRICE protocol—protection, rest, ice, compression and elevation (also known as RICE—rest, ice, compression, elevation).
- Rest, Crutches and Braces: The first 24-48 hours after the injury is considered a critical treatment period and activities need to be curtailed. Use a crutch to assist you during this period. Gradually put as much weight on the involved ankle as tolerated and discontinue crutch use when you can walk with a normal gait (with minimal to no pain or limp). Crutches and air-braces, while conventionally used, are currently out of vogue. Which is such a shame, because braces and crutches give the leg exercise and keep the damaged part from moving and becoming further injured. Support braces can help patients who have either had a recent ankle sprain injury or those who tend to injure their ankles easily. These braces act as a gentle support to wrist movements. They will not prevent severe injuries, but may help you perform simple activities while rehabilitating from a sprained or swollen ankle.
- Ice Pack Method: For the first 48 hours post-injury, ice pack the ankle sprain 20 minutes at a time every 3-4 hours. The ice pack can be a bag of frozen vegetables (peas or corn), allowing you to be able to reuse the bag. Another popular treatment method is to fill paper cups with water then freeze the cup. Use the frozen cube like an ice cream cone, peeling away paper as the ice melts. Do not ice an ankle sprain for more than 20 minutes at a time; you will not be helping heal the ankle sprain any faster, and you can cause damage to the tissues!
Indeed, ice treatment is most commonly used for acute injuries. If you have a recent injury where swelling is a problem, you should be using ice treatment. Ice treatments may also be used for chronic conditions, such as overuse injuries in athletes. In this case, ice the injured area after the strenuous activity. Never ice a chronic injury before activity—icing after activity will help control the inflammatory response.
- Compression: Use compression when elevating the ankle sprain in early treatment. Using an Ace bandage, wrap the ankle from the toes all the way up to the top of the calf muscle, overlapping the elastic wrap by one-half of the width of the wrap. The wrap should be snug, but not cutting off circulation to the foot and ankle. As such, if your foot becomes cold, blue, or falls asleep, re-wrap the bandage!
- Elevation: Keep your ankle sprain higher than your heart as often as possible. Elevate at night by placing books under the foot of your mattresses. Afterwards, just stand up slowly in the morning.
- Heat Treatments: Heat treatments should be used for chronic conditions to help relax and loosen tissues, as well as stimulate blood flow to the area. Use heat treatments on chronic conditions such as overuse injuries before participating in activities. When using heat treatments, be very careful to use a moderate heat for a limited time (i.e., be careful of burns). Never leave heating pads or towels on for extended periods or while sleeping.
- If Symptoms Persist: If it’s been going on for several weeks now and one you’re ankles is that bad (one-sided sprains are mainly is a symptom of portal vein obstruction—usually hepatic in origin) then you must see your doctor. It may well be a symptom of congestive heart failure—liver disease and some kidney problems. In the meantime, avoid salt, alcohol and OTC medication that puts a strain on the liver (ibuprophen can cause water retention in itself).
Prevention of Swollen Ankles
- Physical Conditioning: Sprains can best be prevented by proper use of safety equipment (wrist, ankle guards), warm-ups and cool-downs (including stretching), being aware of your surroundings and maintaining strength and flexibility. Physical conditioning is the best way to avoid or lessen the degree of sprains. In fact, see your doctor from the get go and you’ll be prescribed a diuretic while a proper diagnosis is being carried out.
- Avoid Smoking and Drink Water: Avoid smoking as this strains your lungs, heart and, thusly, the proper circulation of blood to your injury. Drink clear fluid, but don’t overdo it as this can exacerbate the problem, as can too little. Lie down as often as possible and sleep properly. Eat a slightly higher protein diet unless kidney ailments are suspected.
- Pregnancy-Induced Swollen Ankles: Pregnancy is a beautiful thing, but swollen feet and ankles can leave an expectant or new mom feeling not so pretty and uncomfortable. Fortunately, there are ways to reduce swelling. For one thing, drink lots of water. The average human body needs about eight cups of water a day, but a pregnant woman—or one who has recently given birth—needs about 12 to 15 cups of water a day.The best way to make sure you are drinking lots of water is to have a water bottle with you all the time and drink out of it. If you are nursing, try drinking a glass of water every time you nurse your baby. You’ll be amazed at how fast the swelling will go down.
- Proper Posture, Cushions and Massages: Be sure to take time for yourself and put your feet up on a pillow on the couch. If you are at a job that requires standing all the time, be sure to take frequent breaks to sit down for a few minutes. Ask your spouse to rub and massage your feet, using lotion if you desire. This is relaxing and helps the swelling go down as well. Be sure to let your spouse know if your ankle is super tender, because the massage might not be the best thing for you at that point.
More severe ankle sprain injuries, including complete tears of the ligaments and fractures of the bone, may need different treatment and rehabilitation than a simple ankle sprain. It’s also important that you see your doctor before beginning treatment or if your symptoms do not steadily improve over time.
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