and Joint Replacement Dr. James W. Cahill • Dr. Paul E. Kovatis • Dr. Michael C. Distefano
Ankle Sprain Treatment
About Ankle Sprain Treatment
The ankle sprain is one of the most common injuries treated in the emergency room and in physicians' offices. Simply defined, an ankle sprain is damage to one or more ligaments within the ankle. It is a common thought in the general public that all ankle sprains are the same and should universally resolve quickly. Nothing can be further from the truth. It is highly recommended that you see a qualified orthopedic surgeon like Dr. Kovatis to assess the severity and complexity of the sprain so that you can begin proper treatment.
Dr. Paul Kovatis is fellowship trained in orthopedic leg, foot, and ankle surgery from the Hospital for Special Surgery and has over 24 years of clinical experience. Although he has many years of experience in working with professional-level athletes, including the New York Mets, New York Giants, and the American Ballet Theatre, he treats patients at all activity levels. A former minor league baseball player himself whose career was ended by a lower extremity injury, Dr. Kovatis personally understands how an injury can affect an individual both personally and professionally. His goal is to help patients heal so that they can return to their preferred activity levels as safely as possible.
Types and Causes of Ankle Sprains
The ankle joint is a complex structure, including the tibia (shin bone), the fibula (the thin outer bone), and the talus below both of them. Ligaments and other tissues on the sides, front, and back of the ankle help these bones remain stable. The stability provided by these tissues permits running, stopping, pivoting, twisting, changing directions, balancing, etc.
The most common injury causing an ankle sprain is an "inversion" – a term describing the inward twisting of the ankle and foot against a force (think of a baseball player missing a base or someone slipping off a curb). This typically results in what is called a lateral ankle sprain, damaging the lateral (outer) ligament of the ankle called the ATFL (anterior talofibular ligament). Many inversion ankle sprains involve injury to other structures, including fractures, cartilage damage, and tendon damage.
Ankle sprains can also include injuries to a group of very strong, complex ligaments in the ankle called the syndesmosis. These ligaments hold the entire ankle together. Injury of the syndesmosis is much more complex than a lateral inversion sprain.
High Ankle Sprain
The "high ankle sprain" - often mentioned during sporting events - typically refers to ligaments higher in location than the ATFL. Like a syndesmosis injury, high ankle sprains tend to be more complex in nature.
Additional Factors for Ankle Sprains
Ankle sprains can be low or high velocity, depending on the cause of the injury. For example, a low velocity sprain might involve tripping over a child's toy and inverting the ankle. High velocity sprains include car accidents, falling from a height, getting tackled, or tripping over a base while running at full speed. Though there are always exceptions, there is a higher probability of major damage with a high velocity injury versus a low velocity sprain.
Evaluating Ankle Sprains
After determining the extent of the injury, Dr. Kovatis will discuss the treatment plan. Treatment plans can vary from patient to patient, depending on severity and location of the injury and the age and health of the patient.
Initial treatment for ankle sprains is typically conservative nonsurgical, though surgery may be considered if sprains do not improve with conservative care.
Initial treatment for ankle sprains may include:
- Rest, Ice, Compression, and Elevation, (often known as "RICE")
- Assistive devices like a brace to stabilize and protect the ankle
- Crutches or a cane to keep weight off the ankle
- Physical therapy to prevent joint stiffness
- Follow-up visits to Dr. Kovatis to evaluate the progression of the injury
Patients are typically advised to gradually return to weight bearing to avoid reinjuring the ankle.
Dr. Kovatis only recommends surgery if a patient continues to have ankle pain and/or instability despite nonsurgical treatment.
The surgical procedure needed for ankle sprains will vary based on the extent of the injury and if any other structures are injured, as well. The goal of surgery is to repair and stabilize the ligaments. During surgery, Dr. Kovatis will also examine the ankle to see if any other damage is present, and repair it at that time.
Ankle sprain surgery is typically done as an outpatient procedure, and often takes less than an hour to complete, though this depends on whether or not additional damage is present.
Ankle Sprain Treatment in Bergen County
Dr. Paul Kovatis is a fellowship trained orthopedic leg, foot, and ankle surgeon. While his offices are in Bergen County, patients from throughout the NY/NJ tri-state area come to Dr. Kovatis for his expertise. Dr. Kovatis treats a full range of injuries and conditions in the foot, ankle, and lower extremities, including ankle sprains. Though he has many years of experience working with pro-level athletes, Dr. Kovatis treats patients of all levels of activity. His goal is to help patients get back to their desired activity level whenever possible.
If you would like to schedule an appointment with Dr. Kovatis, please call our office at (201) 489-0022.