Classification

An ankle sprain can be classified into different degrees of severity.

Grade 1 represents a slight sprain, this occurs most frequently and is certainly also the most harmless. The ligaments are slightly overstretched but not torn.
The ankle joint is still very stable and often the affected person can still easily occur despite pain.
Grade 2 is a moderate sprain. The ligaments are severely overstretched and one or more ligaments may be torn. In this case, the patient has much more pain and the sprained ankle is therefore more unstable.
Finally, grade 3 is a more severe sprain, often accompanied by severe pain. In this degree of severity, one or more ligaments may be torn. With this degree of injury, the ankle joint is very unstable and the person affected is often unable to put any more weight on the foot.

History

In the case of sprained ankles that are between grade 1 and grade 2 and in the best case without a torn ligament, the foot usually heals after two weeks. Often the foot cannot yet be fully loaded, but the pain should have decreased significantly. Depending on the profession or sport the patient is doing, he or she will receive a supporting splint or bandage for additional stabilization.

Sprains in which one or more ligaments of the ankle joint are torn or even completely torn, the healing process can take considerably longer. In some cases it may even be necessary to treat the sprained foot surgically due to a torn ligament. Since the ankle joint is always subject to enormous stress, it can take some time before the foot can be fully loaded again. In some cases, the complete healing takes two to three years until the ankle is as mobile as before.

Therapy

In the case of a sprain, some measures can be taken immediately to relieve the pain and also to avoid severe swelling.The first treatment of the injury is best done according to the PECH rule. Most sprains subside after a few days and the foot can also be loaded normally again. In some cases, where the ligaments are severely overstretched or parts of the ligaments may have been torn, subsequent treatment with bandages or splints may be necessary.

Cooling and pain-relieving ointments can be applied to relieve the pain. Pain-relieving medications, such as ibuprofen or paracetamol, can also be taken orally. In addition to bandages or splints, a subsequent physiotherapy of several weeks may also be necessary in the case of a 3rd degree sprain.

During physiotherapy, the foot is kept mobile through exercises. Especially when wearing splints or bandages, regular exercises should be performed to prevent the foot from getting into a defective position due to the relieving posture. Regular training under supervision also counteracts excessive muscle loss.

The P stands for pause. From now on, the foot should no longer be loaded in order to avoid aggravating the injury. In the case of sports injuries, one should therefore immediately stop the activity.
The E stands for ice and means to cool the sprained ankle.
Various ice packs or pads can be used for this purpose. Cooling causes the blood vessels to contract. On the one hand, this prevents bruising (haematoma), on the other hand, less tissue fluid is produced and swelling does not become too great.

Cold also slows down an inflammatory reaction and relieves pain.
The C stands for compression. To secure the sprained ankle joint, a compression bandage can be applied immediately after the accident. The compression will secure the possibly unstable joint.
A Cool-Pack or a cooling and pain-relieving ointment can also be applied with a bandage.
The H stands for high camp. The sprained ankle should be elevated as often as possible. It relieves the pain, while at the same time promoting the drainage of tissue fluid and blood.
Swelling thus goes down more quickly and the pressure in the ankle joint is also reduced.

Following a sprain, depending on the severity of the injury, it may be necessary to wear a bandage or splint for several weeks until the foot has fully recovered and the ankle can be fully loaded again. Both options aim to support the ligaments and ensure the stability of the ankle joint. This additional stability is often used to help athletes resume their training and gradually increase the load on the sprained foot.

But also in everyday life and to promote the healing process, various bandages or splints are used for sprained ankles. The bandages are support bandages that are wrapped or prefabricated bandages for the foot and ankle. Another way to promote stability in sprained ankles can be achieved by applying a kinesio tape.

The Kinesio-Tapes are also preferred for athletes, so that they can resume training as early as possible. The tape strips should have a length of about 25 cm. They are applied in such a way that they form a double fan at the ankle joint and preferably cross the ankle.

The tape is attached to the outstretched foot and can therefore adapt very well to the bony structures. There is no need to exert tension on the tape. Taping gives the sprained foot more security and restricts the patient in dangerous movements, thus reducing the risk of a new injury.

Splints that are worn either as a complete shoe replacement or in the patient’s own shoe can also be used. They offer very good stability because they leave the sprained foot even less room for maneuver than bandages. With a sprained ankle, a feeling of instability at the ankle usually occurs in addition to the pain.

Especially in sports where quick changes of direction are necessary, there is therefore often a lack of security in the ankle joint. Taping the ankle can help against this. A distinction must be made between two different types of tape: The normal sports tape is particularly stable.

It should only be worn during stress and helps to support the inner and outer ligaments of the ankle. It is an important support, especially in the early load phases after an ankle injury. The foot is usually taped from the ball of the toe to about five to ten centimeters above the ankle.Since the tape sticks extremely well, this area should be depilated or shaved beforehand.

The tape bandage should not be applied in complete rounds, as this can quickly lead to constrictions with reduced blood circulation. Instead, use short strips of tape, each of which only reaches half around the foot. The more modern kinesiotape is in contrast to this.

It is not only intended to stabilize the foot, but is also designed to support the muscles. The tapes are attached in such a way that they apply traction along muscle strands. This strengthens the natural function of the muscle.

The kinesiotape can remain on the ankle until it falls off by itself. In the case of a severe sprain with possibly torn ligaments, in some cases it may also be necessary to immobilize the sprained foot for optimal healing. In this case, the patient will be given an adapted plaster cast or a plaster boot.

In addition, if the cast is also not to be loaded, the patient is also given forearm crutches. The plaster cast is absolutely gentle on the sprained ankle and does not put any strain on it. How long the cast must be worn depends on the severity of the injury.

As a rule, the duration is about 3 to 4 weeks. After wearing a cast, walking and loading the foot can be very unfamiliar at the beginning. In addition, the muscle mass can also be reduced.

In order to avoid another accident, physiotherapy can also be carried out after a plaster treatment. It is used to train the muscles and strengthen the ligaments and tendons. The most important universal treatment for a sprained ankle is the PECH scheme.

This anagram stands for rest, ice, compression and elevation. Many home remedies can be seen as a supportive measure for cooling. The easiest way to cool the ankle is with a cold pack.

However, care must be taken to ensure that the cool pack does not come into direct contact with the skin, as this can damage it. It is best to wrap a towel around the cool pack, so that it can also be tied directly to the ankle. Alternative methods for cooling are curd or cabbage wraps.

Both cooling applications are simple natural products that can be obtained in any supermarket. If they come directly from the refrigerator, a good cooling effect is achieved. The quark cools additionally by its humidity and also the cabbage leaves can give off liquid by multiple folding.

If the sprain is already a few days to weeks ago, you can also use french brandy. This initially has a cooling effect, but it also promotes blood circulation, which accelerates the healing process. Pineapple juice also has a cooling effect because it is liquid; it also contains anti-inflammatory substances.

Occasionally, a heat application helps in the following healing process. This is especially the case when the actual injury has already healed, but the muscles are still a little weak or the ankle joint is still stiff. For sprained ankles, ointments are used to cool the ankle, relieve pain and reduce inflammation.

The leading ointments are Voltaren® , which contains the active ingredient Diclofenac® , and Docsalbe® , which contains Ibuprofen® . Alternatively, the Doc-Arnica Ointment® , which is based on plant-based active ingredients, can be used. It is important that no blood circulation-promoting ointments are used immediately after the injury. This means that one can start at the earliest after one week (and only then if the ointment does good) to promote healing.