Rehabbing from an Ankle Sprain

Rehabbing from an Ankle Sprain

Rehabbing from an Ankle Sprain

One of the most common injuries we see at New Mexico Foot & Ankle Institute is a sprained ankle.  These injuries range all the way from a simple twinge to a set of crutches and a cast.  The most common sprain is when the foot comes down on an uneven surface and the leg wants to keep going thus “rolling” the ankle.  The pain is usually on the outside of the ankle bone and results in immediate pain and swelling.  The biggest myth we hear on a regular basis is that you can “walk it off.”  After practicing sports medicine for 20 years I have yet to see an injury that was best served by walking it off.  All sprains are considered an injury.  Most of these injuries involve the ligaments that connect the leg to the foot and they are injured by pulling them further than they are designed to go.  This goes from a minor inflammatory response to a complete tear of the ligament.  No matter how badly you sprain your ankle there is a very specific way the treatment should go.

Most people have heard the mnemonic RICE.  Rest, Ice, Compression, and elevation.  The first thing to do with every ankle sprain is to immediately get off the ankle that hurts to stand or walk on.  Stop whatever activity you are doing and get off the ankle.  If it feels like it doesn’t want to be walked on, then don’t walk on it.  The second thing to do with any pain that lasts longer than a few minutes is to apply ice.  If there is any swelling this becomes even more important.  Heat is not helpful at this stage in the game and will make the swelling even worse.  You can safely ice an ankle 20-30 minutes an hour (30 minutes on followed by 30 minutes off).  The third thing to think about is getting some compression on the ankle.  Using an ace wrap works great.  Wrapping the ankle will help with keeping the swelling under control.  This is going to be really important when you want to go back to normal shoes and normal activities.  The 4th thing to consider is elevation.  If it is swollen, put it up.

The first type of sprain is called a grade 1 ankle sprain.  These sprains are mild injuries without swelling it’s just a matter of a few hours and the ice and rest do the trick and the next day it is feeling pretty normal.  If you had one of these count yourself lucky and make sure you don’t do any side-to-side type movements for the next few weeks while these ligaments heal.  Normal walking rarely requires the use of these ligaments that were sprained so people feel pretty good as long as they don’t try and walk on uneven surfaces or turn too quickly.

The second type of sprain is a grade 2 ankle sprain.  If the ankle is still sore the day after the injury but you can walk on it and it is only minimally swollen then an over-the-counter ankle brace can be used for the 3-4 weeks it takes for these ligaments to heal.  The ankle brace will help compress the area and it fits much better in a shoe than an ace wrap and is much easier to walk on.  These types of braces are available at all the local pharmacies and the big box athletic stores.  Remember to not push these sprains too hard.  Do what is comfortable and don’t return to normal activity until the ankle is fully pain-free.   Pushing through the pain or trying to run or exercise on an injured ankle always makes it worse.  Knowing the injury can last up to a month for recovery usually helps to keep us patient with the injury.

The third and fourth types of sprain are grade 3 and 4 sprains.  These sprains involve partial or full tearing of the ligaments.  These are considered moderate to severe sprains and require evaluation by a professional.  We don’t necessarily recommend urgent care or emergency rooms since they are good at giving you ice and crutches and can take x-rays if there is a concern for a broken ankle but most of the time they will still refer you to a specialist the next day.  Many private podiatry offices like New Mexico Foot and Ankle Institute will get you in for urgent injuries within a day and can also take x-rays and will be able to get you into a walking boot rather than a cast.

The best way to tell between a minor sprain that you can treat at home and a moderate or severe sprain that should be seen is the swelling.  If the day after a sprain the ankle is still swollen and looks like a softball or grapefruit on the side of your ankle you need to be seen.  The last thing anyone wants is chronic recurrent sprains on that ankle or a sprain that takes 6 months to heal.  Moderate and severe sprains can take up to 3 months for a full recovery.  Many people have heard that a bad sprain can be as bad as a broken ankle and that can be true.  Severe sprains are best served with a cast or boot for a few weeks followed by a medical grade brace for 1-2 months.  Many patients need formal physical therapy to quickly return to 100%.  Therapy also helps to regain your balance which can be lost when the ligaments are torn.  Many injuries heal well enough to not hurt but people are not aware that their balance is gone until they find themselves with another sprain down the road.

There are also a number of other injuries that can occur with a sprain.  If you notice that a mild sprain still hurts after a few weeks or you have a moderate sprain that doesn’t want to progress with treatment after 3-4 weeks in a boot and brace then often an MRI is needed to evaluate the extent of the soft tissue damage that an x-ray can’t pick up.  There can be damage to the cartilage in the ankle joint itself, the tendons can be inflamed or torn, and other injuries can occur that may need a different treatment plan.

An ankle sprain can definitely be a bad injury but if treated appropriately they rarely cause long term issues.  The vast majority of sprains return to normal function and never result in chronic pain or instability.  There are many home treatments for minor sprains and when in doubt it is never a bad idea to get some help from a professional.  Never live life in pain.  If an ankle sprain is slowing you down come see us at New Mexico Foot and Ankle Institute and we’ll work on a plan to get you back to normal activity as quickly as possible.

 

What’s with the MLS laser?

What’s with the MLS laser?

What’s with the MLS laser?

MLS Laser Therapy

MLS Laser

Here at New Mexico Foot & Ankle Institute we continuously deal with painful conditions.  We see arthritis, tendonitis, nerve pain, sprained ankles, broken bones and lots and lots of deformities that limit activity levels for various reasons, but the #1 reason is pain.  With the 100’s of different problems we see there are still only a limited number of solutions.

Personally, I struggle occasionally with a pinched nerve in my left foot.  Despite my good orthotics and great collection of good shoes sometimes it still bothers me.  It came down to getting a steroid injection or using the MLS Laser on it.  I chose the MLS laser and it worked great for me.  So why chose the MLS laser over a steroid injection?  For me, the answer was as simple as the shot hurts and the laser doesn’t.

Low level lasers have been around for many years and studied extensively and shown to be effective in increasing blood flow to an injured area which in turned helped the healing.  Our MLS laser is short for a class IV multiwave locked system laser.  Additonally, te new MLS laser that we are now using is a high energy laser and overcomes the limitations that the older lasers had of not being able to treat conditions that were deeper down from the skin.  High energy lasers like the MLS laser have been shown to have analgesic, anti-inflammatory, and anti-edema effects.  There is a lot of science behind how this works which is well beyond the scope of this discussion today.

The take home message is that the laser can be used to treat almost all of the painful conditions I see in clinic.  Similarly, it opens another door for us to offer more treatment options to patients who are looking for immediate relief of their pain and for safe and pain free ways to achieve that goal.  The laser worked well for my inflamed nerve and we’ve seen tremendous results with the laser on postoperative patients, slow healing wounds, tendonitis, plantar fasciitis, sprained ankles and many other conditions.  In brief, we are always striving to enhance our services to our patients by offering the best available treatments on the market and this is just another way we do this.

Don’t live life in pain, we now have another fantastic option for returning you to enjoy a pain free active lifestyle.

Call us today for an appointment at 505.880.1000. We take care of your feet…so that they’ll take care of you!

Nathan Ivey, DPM

#topdoctors   #bestABQfootdoctors   #nmfai   #wesavesoles #footdoctors   #podiatrist

 

The Coronavirus & Podiatry

The Coronavirus & Podiatry

The Coronavirus & Podiatry

COVID 19

The Coronavirus & Podiatry

I would like to spend a few minutes clarifying how the Coronavirus, aka Covid19, is affecting the private podiatry practice in New Mexico. Healthcare has been deemed an essential service and has remained open but we have changed who we are seeing and in some cases how we are seeing them. People who have foot issues that can wait have been asked to stay home.

Many of our patients are high risk and skipping a visit could result in an infection or even an amputation. Our goal is to make sure we keep the pressure off the hospitals and to keep people from having to go to the ER or even worse needing to be admitted to the hospital. As we continue to flatten the curve and lessen the stress on the hospitals it becomes more essential that people who have been putting off care of their feet and ankles come in to be seen.

We now know that the healthcare system in New Mexico will not have an overwhelming surge as we initially thought. Our responsibility is to keep our patients safe. Furthermore, we see infections or possible infections in our clinic daily and have always followed protocols and procedures to make sure we don’t pass those germs from patient to patient. Additionally, we have many patients who are elderly or who have multiple medical problems that puts them at high risk for infections.

Each patient is treated as someone who may be carrying a potential cold or flu and we continue to follow strict safety protocols. We have increased this significantly by making sure our waiting room does not break any social distancing rules and our staff screen patients for potential infections. Our goal is a safe environment for anyone to come to our office to be seen so that everyone with foot and ankle issues can be treated safely.

For those times where we can adequately treat via telemedicine we offer that as well. We rely heavily upon physical exam so we will continue to need to see patients in person more than not. Even being stuck at home it can be miserable to have pain and limitations in activity. In order to keep ourselves and our immune systems healthy we need to exercise, even if it is to go for a short walk.

We will continue to provide these essential treatments to anyone in need and we know that fear of infection keeps many people from seeking necessary care. Our commitment is that we will provide that care in a safe and caring environment. Delay in treatment more times than not will result in worsening of the problem and in some cases make it much more difficult to treat or cure. If you have pain or problems with your feet and ankles please call and either make an appointment or be screened to determine if you need to come in. Let us help you get back to a healthy active lifestyle.

Don’t Live Life in Pain! Call us today for an appointment at 505.880.1000. We take care of your feet…so that they’ll take care of you!

Nathan Ivey, DPM

#westandopen #topdoctors #bestABQfootdoctors #nmfai #wesavesoles #footdoctors #podiatrist #coronavirus #covid19

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