Ankle Injuries and Gymnastics

There are different kinds of ankle sprains. Some are as minor as merely needing an ice pack and painkillers for recovery. Some are so severe as to necessitate immediate medical treatment, crutches and physical therapy.

The first thing all gymnasts need to know is: what is an ankle sprain, and why are some sprains more severe than others?

There are ligaments that connect the bones of the foot, ankle and lower leg. Whenever the ankle rolls outward while the foot rolls in inward in the opposite direction, it causes the ligaments outside the ankle to stretch and tear in what is called an inversion injury. Sometimes, the ankle may roll inward and the foot outward, hurting the ligaments inside the ankle. This is known as an eversion injury.
As ligament injuries differ in severity and gravity, ankle sprains are segregated accordingly:

• Grade I: The ligament is stretched and slightly torn, resulting in soreness, swelling and stiffness. The gymnast may complain of minimal pain, but will be able to walk with a limp.

• Grade II: The ligament is stretched and the tear is bigger, but incomplete. The gymnast will feel moderate pain and have a swollen, bruised ankle that is tender to the touch. Moving the injured area will cause pain.

• Grade III: The ligament or ligaments are completely torn, and severe swelling and bruising develops. The ankle gives out if the gymnast attempts to walk and the pain is severe. There will be initial pain that will quickly subside, but if your gymnast tries to get up, he/she is likely to fall.

When to go to the Doctor

Go the hospital if the foot or lower leg is twisted at an irregular angle.
Other reasons to seek immediate medical intervention for a sprained ankle are:

- If you, and others around the gymnast, hear a popping sound at the ankle during a fall or some other similar mishap.

- The presence of moderate to severe pain, swelling and bruising at the injury site.

- The inability to walk or put weight on your ankle, and feeling a wobbly sensation at the injured joint.

- A feeling of numbness and tingling in the area after injuring herself.

- More than two weeks of bruising and swelling necessitate a visit to the doctor.

If the gymnast's ankle is only mildly painful and he/she can carry her weight on it, you can administer the home treatment remedies enumerated below. Immediately dealing with the injury and letting the gymnast go through a series of rehabilitative exercises will ensure that the sprained ankle will heal correctly. If ignored and left untreated, the injured ligaments in the ankle will remain fragile and unbalanced, making her ankle prone to incurring sprains.

How to Treat Mild Ankle Sprains

Keep this acronym in mind: R.I.C.E. – Rest, Ice, Compression and Elevation.
Immediately preceding the occurrence of a sprain, insist that the gymnast rest's while applying an ice pack to the injured area for 15 – 20 minutes. It is advisable to elevate the ankle above chest level during the ice compress treatment. To hold the ice pack steady, you may lightly wrap a bandage securing it to the ankle.

1.Reduces blood in the area where it is applied.
2. Will reduce inflammation, and also numb the hurt area to help ease the pain.
3. When an injury or inflammation such as muscle pain occurs, tissues are damaged and inflammation occurs. Heat will increase blood flow and increase the bleeding. Cold will reduce blood flow to the area and reduce inflammation. Cold also numbs the affected area, which can reduce pain.

View the reusable cold pack

The Gymnast can also do some rehabilitative exercises at home to promote the proper healing of the sprained ankle, and to prevent the onset of chronic pain and joint instability. Not subjecting a sprained ankle to rehabilitation exercises will result in a weak and unstable joint. A quarter of gymnasts who have previously suffered from sprained ankles and who did not follow their rehab or physical therapy regimens, eventually ended up with chronic joint pain and wobbly joints.

Some injury experts recommend an immersion in contrast baths 48 hours after the injury. Contrast baths help in bringing down the pain and the swelling. Prepare a deep basin of ice-cold water that the gymnast will be able to tolerate. Soak the injured ankle for up to half a minute. Following this, immerse the same ankle in another basin filled with tolerably warm water (104 ºF or 40 ºC) for another 30 seconds. Alternately soak the ankle in both basins for five minutes, beginning and ending the soak with the cold water. It will be a good idea to administer contrast bath treatments at least 3 times a day for two weeks. If the gymnast still has swelling and bruising by this time, you should go to a doctor.

Immediately after a minor sprain, the gymnast should start rehabilitative exercises. First, go for short walks to condition the ankle. If the sprain is more severe and walking is painful for the gymnast, you can use crutches or wear a protective brace, or other protective forms of joint support. The doctor will advise the use of these supportive devices until your son’s ankle can bear his weight. Walking will condition the injured area and allow for proper healing.

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Usually, it takes an average of 6 weeks for a sprained ankle to completely heal. Other more severe injuries can take up to 4 months. The gymnast should wear an ankle brace, air stirrup, or any form of ankle support to protect the injured ligaments. After the doctor has pronounced the gymnast fit to train, continue to wear an ankle brace, or tape his ankles to prevent a reoccurrence of the injury.

Stretching exercises are very important. You should undertake a stretching regimen everyday to warm-up before training, and to cool down afterwards. Stretching will go a long way to keep the ankle from getting sprained again. In fact, even if the ankle has been pronounced completely healed, we would recommend continuing with exercises to strengthen the ankle muscles, and drills aimed at enhancing his balance and control. Doing these exercises several times a weak will build up strength in the ankles.

The doctor or physical therapist will recommend the best rehabilitation exercises to help with the injury, and show the gymnast the proper way to execute them.

Other Important Things You Should Know About Treatment

P.R.I.N.C.E. This will most likely make the gymnast feel like royalty!

• Protection – the gymnast should use a protective brace for the first 24 to 36 hours following the injury. Some ankle support devices include air stirrups and compression wraps like elastic ACE bandages.
• Rest – use crutches until you can walk. If the ankle can bear weight minimally, encourage the gymnast to take short walks based on his/her tolerance level. The Rest principle is ultimately being substituted with physical therapy-related Mobilization, or movement. Rehabilitating the ankle will involve subjecting it to as much movement as can be tolerated.
• Ice – apply an ice compress for up to 20 minutes once or twice a day, 24 to 72 hours after the injury, or until the swelling goes down. Subsequently, contrast baths are recommended after 48 hours.
• NSAID’s – this refers to non-steroidal anti-inflammatory medication that you should administer with your doctors permission every 6 hours for the first couple of days following the injury. Some examples are ibuprofen (Advil, Motrin, Nuprin), naproxen (Aleve).
• Compression – to minimize swelling, the gymnast can wear a compression wrap for the first 24 to 36 hours. If the gymnast complains about feeling numbness, tingling, coolness, swelling below the bandage or increased pain, the compression wrap may be too tight and should be loosened. You have to be aware that compression wraps are not support devices. If the gymnast wants to start putting weight on his ankle, he should use a protective ankle brace.
• Elevation – to help decrease bruising and swelling. Elevate the injured ankle above the level of the heart for up to 3 hours a day.