SPRAINED ANKLE

This most common mishap should receive more than casual treatment
September 11, 1955

Both in and outof sports, a sprained ankle is the most common of all joint injuries. Indeed,the ankle seems to have a penchant for spraining. The main reason is that it isa ginglymus—in other words, a hinge joint which, anatomically, doesn't allowfor much play. Furthermore, it is called upon to support the entire weight ofthe body. So long as this weight remains fairly equally distributed, the ankleabsorbs strain and stands up comfortably. But when the weight unexpectedly andviolently shifts, the ankle has to give, and often a sprain results.

Whenever anankle is twisted, the immediate concern is to figure out the position of thefoot when the injury occurred. This may determine right off the extent ofdamage and whether or not it is serious. If the foot twisted inward—as is mostcommonly the case—the ligaments on the outside of the ankle usually have beenpulled (above), and this, while painful, is not always serious. But if the footturned outward, it is possible that a bone was broken. Since both a sprainedligament and a fractured bone cause immediate pain, redness and, finally,swelling, the foot-position becomes all-important, along with an X-ray if thereis any doubt, for selecting the best manner of treatment.

There's an oldsaying that "a sprain is worse than a fracture," and this is all toooften true. Not that the results are any worse. Rather, a sprain, if treated atall, is treated more casually. First aid should be to elevate the foot andapply ice or cold to control the swelling. This should be followed, the nextday or so, by heat and massage. Moreover, the weakened joint should be bracedwith a supporting bandage, a technique to be discussed in a later issue.Depending on the extent of the sprain, you can count on four to 10 days beforeit is back to normal. Meanwhile, exercises should be begun as soon as possible.Start with a simple one: hold onto a chair and rise up on the balls of the feetsix times. Then work up to balancing on the affected leg without support,walking tiptoe across a room, skipping, and finally trotting. These exercisesalso build up chronically weak ankles.

As for walkingor playing on a twisted ankle, if the sprain is the common mild variety, thereis no harm, provided you take it easy. The joint, however, will feel morepainful the next day and may take longer to heal than if you lay off and giveit a deserved rest.

The ankleligaments most commonly sprained when the foot twists inward are the lateralcollateral ligament (1) and the anterior tibiofibular ligament (2), which holdstogether the bones of the leg, the tibia (3) and fibula (4). Rupture of tinyblood vessels causes redness and swelling.

ILLUSTRATIONDR. PAUL PECKNORMAL ANKLE FROM SIDE
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2
3
4
ILLUSTRATIONDR. PAUL PECKSPRAIN FROM FRONT
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2
3
4
ILLUSTRATIONDR. PAUL PECKSPRAIN FROM BACK
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2
3
4

HOLE YARDS PAR R1 R2 R3 R4
OUT
HOLE YARDS PAR R1 R2 R3 R4
IN
Eagle (-2)
Birdie (-1)
Bogey (+1)
Double Bogey (+2)