Sprained ankles: Treatment, recovery and when you should consider surgery

This content is sponsored by MedStar Washington Hospital Center

Dr. Rahnama discusses chronic ankle pain in the Medical Intel podcast. (Ali Rahnama, DPM, Foot and Ankle Surgeon)

Sprained ankles are extremely common – whether you’re an athlete or just inclined to trip, twist or tweak the ankle. MedStar Washington Hospital Center alone sees about four or five cases a week. Despite how routine sprained ankles are, there are instances when ankle pain could be a signal of a longer-term concern that needs to be addressed.

Sprained ankles often occur in athletes, but in big cities, almost everyone is vulnerable, said Dr. Ali Rahnama, a foot and ankle surgeon at MedStar Washington Hospital Center.

“Slips and falls [are common], especially in cities like Washington where people use a lot of mass transit and are walking outside on the sidewalk; we a lot of times see people slip on little patches of ice and things like that and injure themselves and get sprains and even sometimes fractures,” Dr. Rahnama said.

The signs of a sprained ankle are bruising, swelling and inability to bear weight. It can take about two to four weeks to recover from a mild/moderate ankle sprain; it can take six to 12 weeks to recover from a severe ankle sprain.

It’s important to have a period of immobilization, rest and application of ice after an ankle sprain. And after getting medical attention, it’s equally important to connect with a physical therapist who can work with patients on exercises to help them strengthen their tendons and muscles around the sprain to help avoid having a similar injury in the future, Dr. Rahnama said.

Dr. Rahnama said he typically considers minimally invasive surgery when a sprained ankle hasn’t healed after seven to 12 weeks, or when patients experience frequent recurrences of ankle sprains. Repeated sprained ankles and chronic ankle pain can sometimes be a sign that more investigation is needed, Dr. Rahnama said.

“If I have patient who comes to me with an acute sprain … I always ask if they have had similar incidents in the past that they maybe didn’t see someone for and that maybe healed on their own. And that now they are noticing a pattern where they had an initial sprain sometimes up to a year ago, and that as time has gone on … if they continue to have more and more of these incidences, then that’s when I start to consider if it’s something chronic because there are multiple episodes of it,” he said.

Chronic ankle pain can be treated with “straight forward” minimally invasive surgery, which involves making a small incision, entering the joint and removing any type of pre-arthritic or inflammatory tissue that does not belong in the joint in addition to tightening and fixing any damaged ligaments, Dr. Rahnama said.

“A small problem, if not addressed by the right specialist, can a lot of times turn into a much larger problem down the road that could require a much larger surgery,” he said.

Following surgery, patients typically have to stay off of the operated ankle for about two weeks before they take part in resistance and strength exercises to strengthen the muscles and tissues around the foot and ankle.

There are cases when patients come in thinking they have a sprained ankle when, in fact, it’s something else, such as a tendon injury or fracture. That’s why Dr. Rahnama recommends seeing a doctor, getting an X-ray and prioritizing an accurate diagnosis for their pain.

Sprained ankles can be an accident, but there are steps people can take to help prevent the injury. For example, people should choose the right types of shoes for optimal fit and support and also be mindful of the type of activity they engage in, Dr. Rahnama said.

“Runners a lot of times here in the city particularly, it’s best for them to try to avoid … going out for a run right after the snow or the rain. And in the summer months when we are out on trails and things like that, really make sure you familiarize yourself with the terrain before you go out on a run or hike so that you don’t find yourself with any surprises,” Dr. Rahnama recommended.

Getting patients back to doing what they enjoy is core to MedStar Washington Hospital Center’s mission, Dr. Rahnama said.

“We are here to help and make sure patients suffering from foot and ankle conditions can get back to their life and the things they love and be active,” he said. “And so that’s what we do every day and we just want to make sure the public knows we are here and if they need us, we are happy to help.”

Read more about ankle sprains and listen to a podcast with Dr. Rahnama here.

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