“I twisted my ankle” is one of the most common things I hear in my office, and one of the most common things parents of kids that play sports will hear over the years. Kids can do this playing any variety of sports—running at soccer practice and stepping on another player, playing basketball and landing from a rebound on another player’s foot, or going for a shot in tennis and stepping awkwardly. Even if your kids are not involved in sports, they can “roll” their ankles. I have had kids that step off of a curb awkwardly suffer an ankle injury. No matter how it happens, it can be painful. It is important to know what to do and when to worry.
Ligaments are structures that connect muscles to bones. An ankle sprain is damage to these ligaments. As the ankle gets rolled under, the ligaments stretch, resulting in pain and swelling. Sometimes the ligaments undergo only a little stretch, resulting in a minor injury, and other times the ligaments can be torn completely, causing a much bigger problem.
Treating a “Rolled” or “Twisted” Ankle
- Stop!: Your child should stop whatever he or she is doing so that an adult can take a look. This can also prevent further injury.
- Apply ice: This will help ease the pain and will also help relieve some of the swelling that may occur. You should apply an ice bag for about 15-20 minutes and then remove.
- Assess: If the ankle looks dramatically different than the other ankle, if the child is unable to walk, or if the pain is worsening quickly, then the child may need to be taken to the ER to make sure there isn’t an ankle fracture.
Even if there isn’t a need to go to the ER right away, it is important to see a pediatrician, sports medicine doctor, or family doctor if swelling doesn’t improve over a day or two, your child is limping, or if pain is getting worse. Kids that are still growing may have an injury at a growth plate that should be assessed by a physician and may need more treatment.
If your child is diagnosed with an ankle sprain, “PRICE” can be helpful when thinking about how to treat it. This stands for Protect, Rest, Ice, Compression, and Elevation. They should be off the field and not playing, icing 2-3 times per day, compressing with an ACE bandage or brace, and elevating to improve swelling.
Returning to Normal Activities After a Sprained Ankle
It can take kids anywhere from 2-6 weeks to recover from a sprain and be ready to go back out on the field. Here are some tips to know when they are ready to go and the best way to get back out there:
- Wear a brace: I recommend that kids wear a brace for about 4-6 months after a sprain. This allows time for the ankle to regain strength and for the athlete to get back good balance. I typically recommend a brace that laces up because it stays tight for the whole game or practice.
- Practice balance: Good balance is the key to not re-injuring the ankle. Just standing on one foot for one minute is a good way to start. You can make it more difficult by trying to balance on a pillow or cushion that provides an uneven surface.
- No limping!: They should be able to run and cut (stepping from side to side while running) without a limp.
- Ice after!: Icing after activities is really important and can help with soreness that will occur as your child returns to activities.
If you would like to read more about the rehabilitation of ankle sprains visit the Young Athlete Center blog.