Sprained Ankle Heal Time? - Solution By Expert
One week ago I seriously twisted my ankle when I was playing. I guess you'd say that I was spraying it. The ankle was turning purple and swelling and was very painful. Now it feels better but I don't know when to start running back on it. Is it safer to use ice on it, or heat on it? I used both, and it looked like heat was getting better. When is a sprain, and how do I know when I should start running again?
A sprain is an injury involving join supporting ligaments. Any moving joint can suffer from a sprain, but it most commonly occurs in the legs, particularly the knees and anks. This is the product of weight bearing load, and the stresses from sports applied to these joints, including simple running or jogging.
Ligaments are hard, fibrous cords and do not stretch much. These vary from tendons in that tendons bind muscles to the bones to move them while ligaments connect bones for support to other bones. People differ greatly in the stiffness of their joints. At the extreme end of looseness are those who are what is commonly referred to as "double joints." Since their ligaments are so flexible, they are able to contort themselves in ways that most of us can not imagine.
Injury to ligaments is caused by a sudden charge that exceeds the ligament strength. The consequence is that at least to some degree, the ligaments break. This can happen on a microscopic scale, so-called "micro-tears," which will not cause any visible damage to the naked eye. When stressed, the existence of an injury is proven by pain in the ligament. More extreme loads contain "macro-tears," the ones that the examining physician can see in surgery. But that's barely ever needed.
Since internal bleeding happens where you are injured, a purple bruise develops immediately above the ligament that has been sprained. This is accompanied by swelling, which can be noticeable, and when the joint is even mildly strained, there is of course severe pain. This is a serious injury, and can lead to chronic joint problems if not properly cared for.
The acronym, R.I.C.E., encompasses the initial treatment prescribed for sprains. The "R" stands for rest, in order to heal the ligament. Ligament injuries are slow to heal, and take about six weeks in most cases as long as a broken bone is healed. When pain is free the ligament should not be strained again. That responds to the question of when to resume running. Do so when it doesn't hurt any more.
"I" means Cold. All injuries to the ligament should be treated in the early stages with cold rather than heat, up to 48 hours. Cold reduces the bleeding, bruising, and swelling resulting from the tears and healing of the ligament will eventually occur more quickly. Temperature can prove more beneficial after 48 hours. Bleeding and swelling are not so much a problem after this time and warming is bringing more blood flow and healing factors into the region.
Compression stands for "C." This takes the form of elastic wraps that are useful for supporting the joint and reducing swelling around the joint. "E" is for upliftment. This is especially relevant in the lower extremities where gravity in the injured area can cause more fluid to collect, causing more leakage, swelling and pain. True elevation means the wounded place is above the heart level and gravity works in your favour. That usually means lying on one or more pillows with the leg up.
Sprains that are neglected or inadequately handled can result in joint weakening, which can then make it more likely to re-injure. This can build a cycle of injury, inadequate care, reinjury, and insufficient care that can eventually make the joint permanently unstable even. Taping and the other forms of supportive splints available are not a replacement for treating a sprain properly.
An orthopedic surgeon should examine serious sprains, those with substantial bleeding and swelling or in which pain remains for more than two weeks, following treatment as outlined above.