It was many years ago that I had the worst fall of my life. I was taking the garbage out, didn't pay attention to where I was going and fell off the curb. And oh boy, did I do a number on myself. I broke my nose in three spots, ended up with two black eyes, scraped my elbow and rolled my ankle. It was horrible.
Over time, all of those injuries healed—luckily with no scars—but my ankle still gives me trouble from time to time. Doesn't it always seem like ankle injuries heal and then come back again and again?
Same sort of thing happened to my partner, Scott. He thought he was still young enough to play kickball with the kids. He was rounding third, headed for home when he wiped out with a fall. He thought he could just “walk it off" but ended up in a boot.
What's up with ankle injuries? Do they ever really heal, or are they always going to be the injury that keeps on giving? I checked in with Orthopedic Foot & Ankle Surgeon Robert L. Kulwin, MD, from The Christ Hospital to learn all about it.
Ankle sprains are common
Since it always seems like everyone you know has had or is suffering from an ankle injury, I asked Dr. Kulwin what was up with all the ankle injuries. He said, “Ankle sprains are one of the most common reasons for ER and urgent care visits, so it's certainly something that I see a lot. I think most people at some point in their life have probably done it. You know, you're walking down the street, step off a curb, hobble a few steps and it goes away. It's a very wide range of injuries that goes from the embarrassing moment to 'I dislocated my ankle.' An ankle sprain— what it means is a partial or complete tear of the ligaments in your ankle."
When it comes to walking it off just like Scott tried to do, you could be doing more harm in the long run if you don't get it checked out. The “walk-it-off" theory is always an option, but Dr. Kulwin said, “For most people, if you can put weight on it, that's a great sign. In most cases, if you're OK walking on it, you're probably OK to do that. If you have loss of feeling in your ankles, that can be more dangerous. You definitely need to get that checked out. Weirdly, with some fractures that are stable, you'll still be able to walk on it. Those are fractures that we usually treat without surgery."
Sprain vs. Fracture
We've heard time and time again that it is better for you to sprain your ankle than to fracture it. When I asked Dr. Kulwin about that, he said that was true, but it really could good go either way. He said, “Sometimes with certain ankle fractures, they're actually very stable and we can let you walk on them. If you have a higher-grade sprain, you can get some dings in your cartilage, get chronic instability, and your ankle doesn't feel right and gives out. Sometimes a fracture is better because you are kind of one and done, even though it seems like a more serious injury."
Turns out that doesn't mean that you will be plagued with foot and ankle injuries forever. Dr. Kulwin said, “In most cases, people who get a sprain will go on to live their life. Can they roll their ankle again? Sure, but they won't necessarily be more susceptible for their sprains. There is a subset of the population that will go on to develop chronic lateral ankle instability. Loosely, it's described as you kind of feel like your ankle's going to give out on you, you have lots of recurrent sprains, you just doesn't feel stable. If you do get chronic instability, 50 to 70% of people will get better after about three months of physical therapy, but some people don't, and they do go on to usually getting surgery to reconstruct those ligaments on the outside of their ankle."
Injured? Take fast action
Fast action for ankle injuries is still the old and best standard. A lot of people have heard of R-I-C-E but what does that mean? Dr. Kulwin said, “R-I-C-E: Rest, Ice, Compression, Elevation. If a minor sprain or twist hurts for a couple days but it's getting better, probably you're fine. However, if it's been a couple days and it's still swollen or you're having trouble putting weight on it, definitely come in sooner. It's better to be safe and get it checked than sorry. Sometimes a fracture is better because you are kind of one and done, even though it seems like a more serious injury."
Getting medical attention
You don't have to wait to get orthopedic injuries checked out! Our Orthopedic After Hours Clinic is open weekday evenings from 5 – 9 p.m. at The Christ Hospital Joint & Spine Center.
If you'd like to book an appointment with Dr. Kulwin at The Christ Hospital, you can schedule online or call 513-221-5500.