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How to manage an ankle sprain?

Q: I had a fall while playing badminton and during x-ray it was diagnosed as right ankle sprain for which my ankle was plastered and told to take rest for 3-4 weeks by a qualified orthopaedic surgeon. After removing my plaster it was ok for some days after which I had a bit of pain while playing, so again I consulted the doctor, who did some tests on my ankle and was told that its only a joint pain for I was told to take some pain killers (Rofact rt 25) for some days and some rest. But, I still feel a bit of pain when I try to rotate my ankle (part of exercises) and also a kind of creaky sound comes when I rotate that part. Is this a serious case or just a joint pain which can be cured? I am in a dilemma. What might be the reason for this?

A:From your description you seem to be having ankle sprain. However, ankle sprain can be of different grades and different ligaments of the ankle. The most common sprain of the ankle is a sprain of the anterior talo-fibular ligament. This is a ligament that extends from the outer leg bone (fibula) to the ankle bone the talus. Pain in such cases is localised to the front and outer aspect of the ankle joint particularly when you take your foot down and in. Persistent pain could mean: 1. Healing is not complete either because of inadequate immobilisation or a severe grade of injury. In some cases the pain persists for up to 2 to 3 months. 2. Healing may have been good but you have returned to vigorous activities too early. Possibly you need to exercise your ankle before you start vigorous exercises. You could be in consultation with a physiotherapist for this. 3. Even after treatment that is adequate, you could land up with pain because of persistent instability at the ankle or trivial injury / stress to the same ligament causing pain of instability. Since you have already taken plaster treatment, I think you could try an outer heel wedge on the shoe. This will not only reduce the stress but also reduce your pain. You will need to do this through an orthotist (people who make calipers). I must reassure you that it is not a serious case, you should settle in due course of time.

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