By Jason Lauf OMSII

Twisting an ankle is a very common injury across all backgrounds of individuals. It happens in not only athletes or active people, but the casual person walking their dog or walking down the sidewalk to work. Walking on unlevel ground or stepping in a pothole while out walking can cause somebody to twist an ankle. The most common method is stepping on the outside of the foot and forcing the foot to rotate further inside than the normal range of motion allows. Sometimes the ankle can handle the load, but if the load is too high, this action can cause one of two things to happen: ankle sprain or ankle fracture.

Ankle sprains are the most frequent musculoskeletal injury seen by primary care providers. A sprain, not just of the ankle, is the stretching or tearing of a ligament. Ligaments are strong, fibrous bands that connect bones to bones. The ligaments that are usually injured in the ankle are those on the outside of the joint. Ankle sprains can range from mild to severe sprains. The higher the load on the ankle, the worse the sprain. Symptoms of sprains include:

  • swelling
  • bruising
  • tenderness
  • instability

Ankle fractures are the result of higher energy injuries to the ankle. Fractures are a break in bone or cartilage. There are three major bones that make up the ankle joint: tibia, fibula, and talus. The tibia is the shin bone, the fibula is the small leg bone found on the outside of the leg, and the talus is the highest bone in the ankle that can be felt directly below the tibia. Symptoms of an ankle fracture are similar to that of ankle sprains, but also include pain directly over top of the bone.

What is the difference between these two? Is the difference important? The answer to the latter is yes, the differences are important.

Some of the differences occur in the presentation and healing of the injury. Although painful, sprains are able to be walked on, however fractures create too much pain to successfully walk on. Another difference is in treatment method. Sprains can usually be handled at home by the RICE method. This method is Rest, Ice, Compression, Elevation. If there is no improvement in the symptoms after five to seven days, it is worth seeing a physician for potential ligament tear or bone fracture. The physician may prescribe a cast or boot if the sprain is severe or the fracture is mild. Severe ankle fractures are treated surgically. Physicians diagnose the difference between sprains and fractures based on physical exam, x-ray, and CT scan.

Although it is impossible to limit the landscape that needs crossed, there are still ways to help reduce the chance of ankle injuries. If going on a casual walk, the best way to prevent injuries is to wear proper walking shoes. For athletes, other measures such as taping weak ankles, strength exercises, and proper stretching can help to prevent ankle injuries and possibly even ankle lumps.

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