Ankle distortion (twisted ankle, ankle sprain)
An ankle distortion or “twisted ankle” is often the result of twisting or overextending your ankle in an awkward way. Symptoms include pain, bruising and swelling of the ankle. This type of injury is treated at the emergency department and you will be discharged afterwards. You can read more about your injury and what you should do in the coming days in this pamphlet.
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Summary
- You have sprained your ankle as a result of an awkward movement, and the ligaments of your ankle have sustained a partial tear.
- This type of injury almost always heals well without any loss of function
- A routine follow-up is not necessary for this type of injury.
- The pressure bandage that you are given at the emergency department will support your ankle, but does not contribute to the healing process of this injury.
- Walking will result in a faster recovery, try to walk as soon as your pain allows this.
- Try moving your ankle frequently to prevent stiffness. Biking is a good way to practice the movements of your ankle.
- You can find exercises for your ankle in this information or in our Virtual Fracture Care app in the App store (iPhone) or Google Store (Android).
- If you have any questions, or are experiencing problems with your recovery, you can call the 'Breuklijn' (fracture hotline) on workdays between 10.00-12.00.
Treatment
After a sudden awkward movement, your foot can twist to the inside or outside. This is called a distortion, sprain, or twisted ankle. The ligaments of you ankle will be overstretched and sustain a partial tear. Full-length tears of ankle ligaments are extremely rare. This partial tearing can also results in ruptures in some of the smaller blood vessels, which causes bruising. After a distortion, swelling may also occur, usually on the outside of the ankle.
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What can you do if you have an ankle distortion?
- Avoid awkward movements with your ankle, for example by using crutches. You can rent crutches at the hospital. Depending on your situation, you will get a pressure bandage or elastic sock (called a tubigrip).
- A pressure bandage will support your ankle, but does not accelerate healing. You can leave the bandage on for 3-5 days. The elastic sock should be removed when taking a shower and at night.
- Walking will improve your recovery, so try walking as soon as you are able. Try to keep your foot straight when walking to avoid twisting it again. If walking makes the pain worse, stop, and try again next day.
- Avoid stiffness of the ankle by moving your foot regularly, even when you are sitting or lying down.
- Elevate your foot to reduce swelling and pain. Your foot should be above your knee, and your knee should be above the level of your hips. You can put a pillow on your mattress to achieve this.
- Cooling can reduce pain, but will not reduce swelling. You can cool the ankle with ice in a plastic bag or by using an ice pack. Wrap the ice in cloth to avoid frostbite of your skin.
- Cycling is an excellent way to practice moving your ankle.
- Be extra careful when practicing sports that have a high risk of twisting your ankle, such as field sports.
Please note that in The Netherlands you are not insured when driving a vehicle while wearing a pressure bandage or tubigrip!
When will your ankle be re-examined?
Because of the swelling, thorough physical examination of your ligaments is not possible during your visit at the emergency department. This can be done after 4-7 days, when the swelling has decreased. You should make an appointment with your general practitioner for the follow-up examination of your ankle ligaments. In some cases, we will make an appointment in the hospital in the outpatient clinic.
Recovery
Overstretched ankle ligaments
- Overstretched ligaments will heal well over time. For the first couple of days, your ankle may be painful and swollen. After 3-4 days, the pain will gradually decrease and you will be able to put weight on it again. You will no longer need crutches.
- After a few days, the swelling will be reduced. It is common for the heel of your foot, the outside of your foot and your toes to become blue due to the bruising. In a later stage, this color will change to green and yellow and eventually disappear.
- You are usually able to resume all normal activities within 2 weeks, including sports.
Partial tear of the ankle ligaments
- A partial tear of the ankle ligaments will heal well over time. Recovery take slightly longer than it would take for overstretched ligaments. It will take at least 2 weeks before you can resume walking and cycling. You can use crutches in the meantime. It can take several months before you can resume sports.
- A partial tear is treated with a special tape or ankle brace, but only after the swelling has gone down. You can make an appointment with your physiotherapist or general practitioner to do so.
- When your ankle has almost fully healed, it is common that there is some swelling around the ankle after certain activities such as walking. This is normal and not harmful. You do not need to refrain from these activities if this happens.
When contact your general practitioner?
- If the swelling and pain do not improve after 4 days.
- If you still have complaints after 4 days and the swelling has gone down.
- If you need more pain medication.
Virtual Fracture Care app
In our Virtual Fracture Care app, you can find more information about your injury. You can also find exercises here to improve your recovery. You can find the app in the Appstore (iPhone) and in the Google Store (Android). You can also scan the QR-code, automatically you will be transferred to the app.
Questions? Please call the 'Breuklijn'
If there are any questions after reading this information, please call the 'Breuklijn' (fracture hotline) on work days between 10.00-12.00.