It can happen so quickly. One minute you’re double stacking rafts on a trailer for a week of boating. The next minute, you’re on the gravity train. The sound of a twisted ankle popping under the force of body weight in gravitational pull, makes you cringe.
Naturally, you start assessing the extent of your injury. Is it broken? How serious is this?
In the end, it was just a sprained ankle. I was provided assurance of this by my friend, Dr. Mike, whose official diagnosis was, “I don’t think it’s broken, shall we go boating?”
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Ankle sprains are common, especially in sports. I’m not sure if preparing to go boating is considered a sports injury. Rather, just clumsy. Regardless, the result is the same, pain, swelling and limited mobility.
Statistically, most people won’t seek medical treatment for a mild to moderate sprain. Instead, we practice self care paired with the wait-and-see approach. Chances are, the ankle will heal. However, once a sprain is experienced, 33% will continue to have chronic ankle instability.
That evening, with my leg elevated and ankle resting on a bag of ice, I wondered two things. First, when will my ankle be better? Second, how do I avoid chronic ankle instability? Because frankly, this is not awesome.
You may be familiar with the acronym RICE. It stands for rest, ice, compression and elevation. It has been a recommendation for decades, though not rigorously investigated for efficacy.
A 2018 consensus statement from the British Journal of Sports Medicine says there is insufficient evidence RICE alone will improve pain, swelling and function in a lateral ankle sprain (the most common type of sprain). That’s OK, the ice was melting on the couch anyway.
Still debating the best course of action, I notice my golf ball of an ankle is throbbing. Pain medication is in order. Ibuprofen and acetaminophen seem to be equally as effective for reducing pain. In that case, I’ll wash one down with the melted remains of my ice. But beware, taking ibuprofen isn't without side effects, especially if taken consistently over time. And, ibuprofen may slow healing because it reduces inflammation.
Three days post injury, the rafts are in the water and I must decide, should I stay or go? The consensus statement says immobilization with rigid ankle support for less than 10 days may be of value. I take that into consideration, knowing that in 10 days I could watch every Netflix show of interest. But, rafting is way more fun. With rigid support in place, I hobble into the boat, thankful to have my own space in the back, while kids argue up front.
The $25 brace was a good investment. Both rigid and lace-up braces work significantly better than compression bandages or kinesiotape. And, in most cases, mobility advances healing over immobility. Now, whether an expert in musculoskeletal injuries would agree rafting was the best choice for staying mobile is uncertain, but I have my speculations.
For those still on the wait-and-see plan, consider exercise therapy. When initiated early, it’s associated with a quicker recovery time and improved outcomes. What needs further investigation is whether exercise therapy needs professional supervision or not.
In answer to my initial wonder, an ankle sprain takes longer to heal than you’d expect. Mentally prepare yourself for it to take weeks, or months, before you’re back to normal. That’s the best case scenario.
Luckily, my kids don’t read this column. For now, they still think I am unable to do dishes. They clearly haven’t questioned this belief and I’m in no hurry to bring it to their attention. Share what you’ve learned, but the last is our secret.
Nicole Clark is the family and consumer science agent for the La Plata County Extension Office. Reach her at firstname.lastname@example.org or 382-6461.