We all have been there. A single misstep and your foot hits an uneven surface, and your ankle twists, rolling inward usually, causing a tremendous amount o…
We all have been there. A single misstep and your foot hits an uneven surface, and your ankle twists, rolling inward usually, causing a tremendous amount of pain in the outer ankle, rapid swelling, and bruising. It is very common to hear an audible “pop” but this can be a dislocation of a tendon after the fascial tissue tears, and we must always consider a fracture. Often, an exam after the acute injury is warranted to determine if there could be a fracture and if x-ray is warranted. A doctor will use specific criteria to determine if the bones are at risk for having fracture, and order films as needed.
In the majority of ankle sprains, there is usually no bony injury unless there is some direct trauma to the ankle joint itself. With the criteria in mind, an ankle with a certain appearance and exam will beget an x-ray. Again, most will show no bone damage or fracture. Then, what happens really depends on the setting of your evaluation. If the pain of weight bearing is too significant, a compression wrap may be applied for comfort, and a set of crutches to keep weight off until the ankle improves. Again the basic principles or rest, ice, elevation and compression are simple rules to keep in mind.
For greater comfort, emergency rooms and officesalso dispense either what is called a walking air-cast that supports the ankle with air pumped cushions around the ankle mortise, held on by a sole strap worn inside the shoe. The air compression covers the lateral and medial aspect of the ankle, and extends up the calf. This type of ankle orthotic is simple to apply, cost effective, and typically promotes the ability to ambulate. For many patients, although effective, this brace may feel more cumbersome. The most common medicare ankle brace to be prescribed is an orthotic brace that pulls onto the ankle joint and laces up, tightening the brace and ensuring stability. These are worn on the ankle often over the sock, and inside the shoe and are often preferred when swelling has decreased some, especially by athletes.
The variety of medical orthotic braces available are numerous and plentiful. Typically an ankle that has chronic pain either from joint arthritis or instability can be treated long term with a lace up brace or a neoprene type sleeve worn during activity. The goal is comfort and stability, and many medical supply companies sell various versions direct to the consumer, are readily available at pharmacies, or are obtained with a physician’s order. Medicare orthotics and even insurers such as Blue Cross and other health plans have simple basic requirements to have this equipment covered at typically a maximum of a 20% copay.