A wrong step, an awkward landing during a jump, and suddenly the ankle is strained. Right after the incident, there is only pain, but soon the ankle is swollen. A joint sprain (distortion) is one of the most often occurring and the most frequently treated sports injury in sports medicine. Nevertheless, the injury can be treated without further damage to the joint if treated appropriately. With an optimal treatment, this type of injury heals quickly.
What happens in a joint distortion/ankle strain?
In a joint distortion, the capsule or ligaments of a joint are injured through external forces, such as a fall. The extent of the damage depends on the severity of the force. In mild sprains, the fiber structures are simply overstretched, while with a strong force, it may come to a partial or even complete tear of the ligaments and joint capsule. The result: a more or less pronounced instability of the affected joint.
What are the typical symptoms of a sprain?
Fuesse auf BarrenThe most noticeable symptoms of a distortion / sprain and consequent torn ligaments are pain and swelling of the joint. Moving is painful, but usually still possible. However, if the affected joint can no longer be moved or endure weight without excessive pain, it must be assumed that the bone is also injured. Depending on the severity of the injury, the joint might also have become unstable.
The most important measures to be taken immediately after a joint distortion/ankle sprain!
A distortion / sprain must be treated immediately since the affected joint needs to be protected. To treat the pain and to prevent a large hematoma, the joint should be cooled directly (with ice packs or ice wraps). A supportive, slightly compressing bandage helps to keep swelling of the joint down and protects the injured structures. In addition, the joint should be elevated. Further examination and treatment by a physician may be needed.
How is a joint distortion/ankle sprain exactly diagnosed?
A comprehensive physical examination supplemented by ultrasound, X-rays and possibly MRI scans, performed by an experienced sports physician determines the exact extent of the injury. An accurate diagnosis is very important because the treatment required depends on the severity of the injury, meaning it depends on what structures (joint capsule, ligaments, cartilage) have been damaged.
What are the treatment options for torn ligaments?
In minor injuries, where the joint capsule and ligaments have been overstretched or only slightly torn, the affected joint is stabilized for one to two weeks with a light elastic bandage. Protecting the ankle from excessive activities and applying appropriate ointments, usually supports a quick healing process. With more severe sprains in which it has come to an injury of the joint capsule and/or torn ligaments, the joint needs to be treated more intensively since otherwise the sprain can results in a permanent joint instability. This can lead to premature joint wear (osteoarthritis).
Generally, a surgery is not necessary!
Just a few years ago, it was thought that torn ligaments have to be sutured in order for them to heal, meaning surgery was performed routinely. We know today that this is often not the best treatments. The injured joint capsule and torn ligaments heal in most cases just as well when supported with a special brace (e.g. aircast brace). For a complete healing of the ligament, a brace has to be worn for about six weeks.
Only in the most severe cases of ligament injuries with correspondingly severe joint instability, a surgical reconstruction of the damaged capsule-ligament is necessary. Usually in these cases, there is also simultaneously a bone injury. After a surgery, the injured joint needs to be kept immobile for about four to six weeks.
What is rehabilitation like after a torn ligament?
The healing process of a capsular ligament injury can be greatly supported through appropriate measures taken by the patient. In the acute phase, i.e. during the first three to four days after the injury, the injured joint should be treated with cold packs as often as possible. Additionally, ointments or curd wraps are helpful to relieve the pain and support the healing process. Medications reducing the swelling should also be taken. Physical therapy, especially lymphatic drainage, is very effective at this early stage.
Starting four to five days after the injury, the self-healing tendency of the body should be supported by means of metabolic stimulation: Particularly suitable for this purpose are popsicles/ice-lollies that are rubbed onto the affected area with ice for 10 -12 minutes at the time. Helpful is also mild heat or bathing the ankle alternative in warm and cold water. Physiotherapy, such as electrotherapy, can support the healing process. Physical therapy of the surrounding structures will help prevent the weakening of the affected muscle.
Once the healing of the injured joint has successfully progressed, you can start with a very mild weight bearing exercise program. At this stage, the focus should be on joint-stabilizing exercises and exercises to improve coordination and proprioception. Proprioception or depth perception ability means to perform the joint position consciously and reflexively.
Important is that the joint be brought slowly to bear weight. Particularly heavy and rapid movements (fast directional changes, jumps, etc.) must be avoided. These are advisable usually only after six to eight weeks. During the first weeks of sports activities, a light supporting bandage or wrap may be useful.
What can I do to prevent an ankle sprain?
A good training condition and careful warming up before sports activities minimizes the risk of an ankle sprain considerably. Suitable sports equipment, in particular adequate sports shoes are important. Another preventive measure is to bandage the joint that vulnerable to injuries to better protect it.
Who specializes in the treatment of joint distortions or torn ligaments?
The orthopedic team at the KLINIK am RING specializes in the treatment of all sports injuries, conditions, and diseases. The team relies on a founded expertise and comprehensive experiences and also offer consultation on professional treatment options and methods to amateur athletes.