Severe Ankle Sprain

[MrPhysio+]

Hi Ambersue,
The best way to reduce the initial pain following your ankle avulsion fracture is to reduce the amount of swelling - quickly.
The inflammatory fluid creates pressure against the damaged areas (both splinting and compressing sensory nerves causing pain) as well as containing a nerve irritant that increases in concentration the longer the area is kept still - hence increased pain at night.

You can use contrast baths to reduce swelling - Two rectangular mop buckets are needed. Partially one with luke warm water, the other two thirds full of cold water and one third with ice slush leaving enough room to avoid overflow when your foot is immersed. Put your foot into the cold bucket for 20 seconds, then the warm bucket for 20 seconds and repeat the sequence for a total of 5 times. You can do this twice a day. At other times have the leg elevated and gently move your foot backwards and forwards - the contraction relaxation of the calf acts like a pump to assist in fluid removal and gravity helps as well (ankle higher than the knee and knee higher than the hip).

If you are moving around once some swelling is reduced, a tubular compression sleeve is good, but not too tight.

Although this is a bit controversial, I prefer my patients not to take non steroidal anti inflammatories in the acute post injury stage as they can interfere with healing times and increase bleeding. The idea of a cam boot is a good one, allowing you to get around whilst supporting the ankle.

Once you have stabilisation of the fracture it is very important to start ankle balance exercises as your balance will be badly affected and if not retrained will increase your chance of further ankle injury.

Let us know how you proceed with your healing rehab.
Regards,
MrPhysio+

[jojosephine]

Hi Ambersue,
The best way to reduce the initial pain following your ankle avulsion fracture is to reduce the amount of swelling - quickly.
The inflammatory fluid creates pressure against the damaged areas (both splinting and compressing sensory nerves causing pain) as well as containing a nerve irritant that increases in concentration the longer the area is kept still - hence increased pain at night.

You can use contrast baths to reduce swelling - Two rectangular mop buckets are needed. Partially one with luke warm water, the other two thirds full of cold water and one third with ice slush leaving enough room to avoid overflow when your foot is immersed. Put your foot into the cold bucket for 20 seconds, then the warm bucket for 20 seconds and repeat the sequence for a total of 5 times. You can do this twice a day. At other times have the leg elevated and gently move your foot backwards and forwards - the contraction relaxation of the calf acts like a pump to assist in fluid removal and gravity helps as well (ankle higher than the knee and knee higher than the hip).

If you are moving around once some swelling is reduced, a compression sleeve for ankle sprain is good, but not too tight.

Although this is a bit controversial, I prefer my patients not to take non steroidal anti inflammatories in the acute post injury stage as they can interfere with healing times and increase bleeding. The idea of a cam boot is a good one, allowing you to get around whilst supporting the ankle.

Once you have stabilisation of the fracture it is very important to start ankle balance exercises as your balance will be badly affected and if not retrained will increase your chance of further ankle injury.

Let us know how you proceed with your healing rehab.
Regards,
MrPhysio+

Useful information. I did the same when my ankle was injured. Repeated cold / hot compresses, using compression socks, and ankle balance training. Since I was no longer young, it took me a long time to get his ankle back. I still use compression stockings to keep my ankles stable.