3 Steps To Take Care Of A Recently Sprained Ankle
In this video, I’m going to show you three steps that you need to go through to take care of your recently injured ankle. I’m Dr. David Middaugh. And I’m a specialist physical therapist at El Paso Manual Physical Therapy. And this channel is dedicated to helping people stay healthy, active and mobile, while avoiding unnecessary surgery, injections and pain medications. Please consider subscribing to our channel so that you don’t miss out on any of the helpful tips that we post every single week. Let’s get right to it.
The first thing that you got to check for if you just entered your ankle is to make sure that you don’t need to go to the hospital or to go see some health care professional because if you do, you want to go quick, you need to make that decision kind of quick. So I’ve put tape on our model here to show you some very important spots you need to take a look at.
I’m actually following a research base protocol called the Ottawa ankle rules. You can Google this, it’s very well researched. And what these rules tell us is if you have any one of these on you which all I’ll tell you in detail here in a second, then you’ve got to go to the doctor you got to get an x ray and get cleared. Number one thing is your anything deformed.
If you just look at your legs or a bone sticking out that wasn’t there before that looks completely different from the other side is even all the way up here there’s a little bone on the outside of here called the fibula, that’s the one that most commonly gets affected with ankle sprains special on the outside of the ankle. If that seems like it’s out of position, of course, you’re going to be a lot of pain. But if it is, obviously out of position, you need to go right away to the emergency room er, go, go get an x ray and figure out what’s going on.
The next step. If there’s no deformity is if you have tenderness in any of the spots that I’ve put tape on our model here. If you look on the on the ankle bone on the outside of here, this is the bone, kind of on the back half of it. But really any part of it if you have tenderness, especially in that back half of it, if you poke it, and it just really hurts, that’s a sign that you need to go to the hospital. On the outside of the foot of your there’s a bump on the outside of your foot, that’s actually called the fifth metatarsal. It’s the bone that sits at the base of the little toe.
That part right there often on a lateral ankle sprain, like when you bend your foot this way, there’s a tendon that runs to here and it can if you’re if you roll your ankle far enough, it’ll pop the end of the bone off. And so you might get pain and swelling down here in this region. And I put the same tape on the other foot just because it’s hard to see her foot from this angle, he put your foot up this way, just put your do like a finger for like this.
Yeah, but put your foot flat and drop your knee up. Yeah, like that. You can see the tape right here. But I have to get up, move the camera around everything set up kind of nice in here. But if you look at our other side here, the inner ankle bone is another spot that you can get a break or a bit of fracture at. So also poke around there. If it’s tender there, go to the hospital. And then there’s one more spot, if you look on the arch of your foot right here on the inside part where you feel the biggest bump, that’s a bone called the navicular.
I put tape right over, it’s not too far away from the ankle bone here. If you have tenderness there, if you just kind of gently poke it, then that’s another reason to go to the hospital. So four sites, you should check to on the inside on the ankle bone right here and on the foot. And then bring your foot down on the outside ankle bone, and also on the side of the foot here, if those spots tend to go to the hospital.
And then one final thing you need to check is if you cannot put weight on your foot right after the injury, like let’s say you rolled your ankle, and you that was it, you couldn’t stand on that leg anymore, then you need to go get an x ray, if you can put weight on it for a little while right afterwards. But then it hurts because it swelled up or something and then it hurts to put weight on it.
That’s a different situation. And what these rules tell you is it doesn’t confirm there’s a break, there’s still a high chance that you don’t have a break, it just confirms that you need to go get it checked out, it’s a very good idea to go get it checked out. I think the success rate of these clinical rules was like over 95%. So if you have tenderness at these spots, if you can’t put weight on your leg right after you get hurt, and if there’s any sort of deformity like this, then you need to go get checked out.
If none of that’s going on, you just kind of rather mildly or moderately hurt your ankle, then you might be okay not seeing the doctor, you might still go for your peace of mind. But then you need to start doing the things I’m going to talk about next to get the swelling and pain under control for your ankle problem.
So if all that checks out, you’re not going to the hospital. Great news. Now you’ve got to practice rice, our ice that’s an acronym for Rest, Ice, Compression and Elevation. The first one rest is just like what it sounds like you’re going to just get off your feet for a while. If you have been walking or doing any sort of activity you need to stop and rest.
And then what I like to call relative rest as we you should practice in the coming days, meaning you might still get up and move around. But you need to take a kind of easy only walk what you absolutely need to. If you can bear weight on your foot isn’t hurt very much. Then just keep the walk into minimum otherwise you are going to irritate the injured tissue. not let it heal, so you just need to chill out for a bit. As far as ice put ice right over where it hurts.
Could you hand me that pack right there? So I’ve got a hot or cold pack here, this one’s cold, you just hold it in the freezer, and there’s different types out there, you could use a bag full of ice cubes. Or, you know, frozen vegetables is the common old one that people use. This one is filled with a gel that can be microwaved or in the freezer, and you would just wrap it over just like so just to give it some cold to keep the swelling down. Now, there is all kinds of mixed research about whether or not the ice really helps, but it generally feels good.
It’ll numb your skin, which substitutes a pain reliever. Notice rice doesn’t mean us Tylenol, or ibuprofen, which if you choose to do that, as long as it’s safe for you to do so you could use over the counter pain medication. But ice might be enough pain relief for you to skip these pain medications.
The next one is compression, which the weight of this is might be enough compression for you. But you might use a rap as well. so heavy that rap please, you want to use rap, we have this array here. And I’ve got another video that goes into detail about how to do this, I’m going to do this kind of quickly, we’ll link that video in the description. And all you would do is slide this way just a bit, please.
Perfect is to start this over the top stretch a little bit just to get some compression going from this, this is a stretchy band. So it adds some compression. And just try to minimize the creases, the wrinkles in this here. And you just go around in a figure eight pattern like so crisscrossing over the top of the foot and ankle until you run out of fabric. And then you would just cinch it in place. Not going to go under the foot. And since you don’t have cinch it on this side over here. Got the little clips, clips right here, metal hooks. There you go.
So that would be compression. And then the elevation part a lot of people mess up, they think that just getting it off the ground is enough as she’s in here. But if the higher you can do it, the better especially relative to your heart.
The reason for the elevation is because you’re trying to use gravity to reduce the amount of fluid pulling down in your leg and ankle. So, if you’d like down right there, that way your hearts now level with their foot. And if you’re able to get enough pillows under your leg to put it up this high, I mean as high as you comfortably can without stretching things or getting any sort of pain from being up in this position, the better it is for you.
A common one is people will lie down on the couch with their injured leg towards the back of the couch. And then they’ll get their foot over the top edge of the couch and rest it there, you might just stack a bunch of pillows, under your leg in bed or on the couch as well.
Another option is lying down on the floor with your legs up on the seat of the couch or on a chair just to get your leg as high as possible. And you want to do that for as long as you can tolerate if you can hang out there for 30 minutes or an hour. That’s generally better for you. But you still have to go through the healing process.
If you sprained your ligaments out there you injure the cartilage or whatever the injury might be your tissues are healing and it has to go through the healing process. No matter how much you elevated after a certain point, it’s not going to speed things up. All you’re trying to do right now at the beginning of this injury is get it under control so that you can tolerate being on your feet at the end of the day or by the next day.
Next, we’re going to talk about how to use crutches so that you can avoid putting any weight on your ankle to allow it to heal as fast as possible, or at least allow you to get to an emergency room or healthcare so that you can get an x rayed. So now we are going to show you how to use crutches. Let’s say you can’t put weight on that right foot. That’s something you want to protect right now.
Get your crutches which you can find at pretty much any drugstore, they should have some standard crutches like this, they’re adjustable, they’re usually like a one size fits all. Even bigger kids can use these if you if you size them down all the way if you, they telescope in and out they’ve got these buttons, and this one goes as low as four seven, you’d have to adjust the this arm height. And you can also take off this this little wing nut right here and adjust the hand position the hand grip position here.
These are fully adjustable the range anywhere from 30 to $40. And if you need to run by Goodwill or you know a thrift store Salvation Army, one of those chances are you’ll find crutches in one of those places as well. But knowing how to use them so you don’t put any weight is something I get asked all the time. So, I’m going to show you exactly what to do.
So go ahead and grab these by the handles right here. And the idea is that you’re going to stand up putting weight through both of these hands and the leg that isn’t bothering you the one that’s not hurt this leg you’re going to kick out and not putting the weight through. So, when you Come up, you’re going to lean on to your hands quite a bit, kick that right leg out. Yep. Perfect. And then get those under your arms. Awesome.
So just take one little step forward here, just so we can see how you do it. Yep, she did a step two pattern, which just means you move the crutches forward a bit, and then the lay that you can put pressure on you, you step two, even with the crutches. So, we’re just going to take a few steps back and forth, by the way. Yep, there you go. And go ahead and turn around, you can, you can choose to hold that leg out that way or bend it whatever you want.
Just keep in mind, he’s gone back and forth here one more time. Keep in mind that you’re not going to cross very far. If you’re on crutches, you should not be, you know, going to the grocery store very much. If they have those carts, you can, you should use those carts. Perfect step through pattern through and has a seat. Let me just give you a few more tips about the crutches I’m holding the seat for you. Okay, perfect.
You might even play with how you adjust them. You want to be careful with resting your armpits on these pads is not comfortable. Especially if you’re on your feet for a while you have to just be you know travel because say you know where you live, you have to it’s far from where you park or you don’t have a car or whatever the case may be. So, you might want to put some padding on this, just so it’s more comfortable in your armpits, and it is an arm workout, your arms going to get so tired.
If you don’t have very much arm strength or endurance, you need to plan for that. And in some cases, it might be better to get a wheelchair and get some help from somebody. But crutches really are the fastest solution if you’re decently strong and you can get by and your other leg and your arms, this is going to be the fast way to get around. So that you can optimize how high to put the crutches going to stand up here.
It’s okay if you were waiting on that, but you don’t have to pretend you’re hurt. Or you could just put them under. When you grab the handles go and grab the handles, you should have just a little bit of an arm bend right here you shouldn’t be reaching to the handle. And this part right here shouldn’t be jammed up in your armpits, you might lower it about an inch or a few centimeters away from your armpits as well. So that when you stand up, you should feel like you can lean down onto them. Yeah, perfect like that.
It shouldn’t feel like you don’t go anywhere where you lean down that that way you have the most mobility to move the crutches and take steps as you need to get I’m just going to give you a few more tips that you need to understand and make sure you pay attention to so that you can know how to handle your ankle injury.
If you aren’t getting better in about two or three days after a recent ankle injury, you need to go to the doctor you need to go get some professional help to make sure that you don’t have a fracture, or some massive ligament sprain that might need a more comprehensive brace than just an ankle wraps like this.
You might also need to see a physical therapist or some other specialists where you might need surgery in some cases as well and you don’t want to delay too much on seeing a specialist to make a determination on what you need for your ankle. And that being said generally one to two days at the very most three days is all I would wait if you feel like after two days or so you’re improving it’s getting better than you might be able to skip seeing the doctor.
It could just be an injury that’s going to resolve on its own without much help from a doctor some people like to take the risk and see how far they can get in that situation and others will go to the doctor just for peace of mind to make sure that they didn’t miss anything and that it’s going in the right direction just in case a document have any other recommendations or they might need pain medication.
That’s kind of high power from the doctor that would be another reason to go see your doctor. Hey, you thought this video was helpful please give us a thumbs up and don’t forget to subscribe so that you don’t miss out on any of the helpful videos we post every single week. We’ll see in the next video guys.
