If You Do the Twist...

Without proper care, a sprained ankle can become a chronic injury.

Just about everyone has twisted an ankle at one time or another; ankle sprains are the most common athletic injury. However, if they're not treated right away and completely rehabilitated before you return to action, they can become a chronic problem.

The ankle is a complicated hinge joint composed of four bones and four major ligaments. The bones are connected by the ligaments, fibrous tissue that gives the joint stability. The ligaments will tear if their range of movement is exceeded. A sprain can range from mild to severe, resulting in equivalent amounts of instability in the ankle.

The most common ankle sprain is an inward twist, with the foot turning underneath the ankle. The three lateral ligaments of the ankle may be so severely torn that you're unable to bear any weight on the injury. Or the sprain might be so mild you can "walk it off" and continue your activity.

In either case, proper treatment and rehabilitation are essential to prevent a chronic problem from developing. The initial treatment for all sprains is RICE: Rest, Ice, Compression and Elevation.

Rest Rest the injured ankle, avoiding any activity that causes further pain. Meanwhile, you can maintain conditioning with activities that won't stress the joint, such as riding a stationary bicycle, using a rowing machine or swimming with leg floats.

Ice Apply ice as soon as possible. Ice decreases pain immediately by numbing the skin and reduces swelling by constricting blood vessels. Much of the pain from an injury is caused by swelling from torn blood vessels. Controlling the swelling helps you make a speedier recovery.

It's best to use crushed ice in a watertight bag covered with a thin cloth so it's not too cold against the skin. Apply it for 15 minutes directly over the area of swelling. Longer applications may cause a rebound dilation of the blood vessels and may actually increase swelling.

Apply the ice every four to eight hours as long as the swelling continues (even as long as a week). You can use chemical ice packs, but many experts warn that because they do not melt the same way as ice, they can overcool the ankle and cause a chemical freeze to the skin.

Next: Compression

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Foreword: Billie Jean King

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