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Managing a Persistent Ankle Injury

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By Mary Ellen Ostrander

Opps! I did it again. Whether your child’s ankle injury is from school sports, weekend athletics, or just misstepping the exit ramp of the school bus, mismanagement of this ankle injury can lead to persistent symptoms. Yes, it might even dog them for two years or more. If the student is over weight, he is at greater risk for ankle trauma and more likely to have a much slower healing process.

Today students participate in many activities, everything from traditional sports to ultimate Frisbee and skate boarding. These pastimes place high demands on ankles and may lead to recurrent injuries. As you might expect, a previous injury can increase the likelihood that the child will sustain another ankle injury. Why does this happen? An injured ankle can leave an individual with mechanical instability; balance is compromised with one side of the body stronger than the other.

If your child’s ankle suffers recurrent stiffness or swelling, the injury has not healed. Left untreated, the ankle might sustain long-term degenerative changes and be susceptible to future injuries since the injury will restrict movement and strain the healing tissue.

The goal with any ankle injure is to protect, rest, minimize pain, and decrease swelling. Students are always encouraged to seek medial assessment with ankle injuries because a secondary injury may go unnoticed.

The immediate treatment is to apply ice, an effective anti-inflammatory. For the ice to be effective, place it over a thin layer of clothing or ace bandage to protect the skin. A good rule is to maintain the ice for 15 or 30 minutes, several times a day for the first 36 to 48 hours after the injury.

Compression with an ace bandage to relieve and control swelling also can protect and support the joint. Elevating an injury will help to reduce blood pooling and decrease the inflammation that may impede healing.

Rest can be the biggest challenge a student faces in healing. Even when the doctor orders the student to stay off the ankle, a young person may be embarrassed or not want to bother with crutches and spend the entire school day limping from class to class. Putting weight on the ankle will certain hamper recovery?

The best treatment for ankle injury is prevention, beginning with wearing footwear that supports the ankle. Students should practice proper body mechanics (bending knees when lifting, for example), follow a healthy diet to control weight, and warm up properly before exercising. A student who has sustained an ankle sprain in the past, might want to have the ankle taped for certain activities.

Student athletes should never resume sports until the ankle has completely healed. The school nurse, parent, and coach need to communicate about the student athlete’s ability to resume practice.

An ankle injury undoubtedly can affect the quality of your student’s life and overall physical health and well being now and into the future. If your child sustains such an injury, stick to the doctor’s treatment plan so the ankle fully heals. This does take time and patience, something young people have in short supply. So keeping on top of the situation is a must for a parent. Don’t worry. Sometime in the future, he’ll thank you.

Mary Ellen Ostrander, R.N., is a school nurse in Brooklyn.

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