Kids and Ankle Sprains

Ankle sprains are very common in pediatric and adolescent athletes. Children in all types of sports are at risk, but certain sports can put kids at greater risk for an ankle injury. Those that require cutting maneuvers like soccer, basketball and tennis -- or sports that require tumbling like cheerleading, gymnastics and dance are among the most common sources of ankle sprains. We talked to Dr. Derek Kelly, orthopedic surgeon at Le Bonheur and Campbell Clinic, about these injuries. Here's what he had to say:

The typical ankle sprain occurs when the foot rolls inward, while a force or the child's body weight is applied to outside part of the ankle. This type of injury puts a great deal of stress on the ligaments (which hold the bones connected to each other) on the outside part of the ankle. Sometimes the ligaments are simply stretched, but occasionally they are torn. The ankle will swell and hurt, and there will often be bruising that collects near the sole of the foot.

Initial treatment for ankle sprains is R.I.C.E.: rest, ice, compression and elevation. The child should protect the ankle from further injury by resting and limiting weight bearing activities. In some cases, an X-ray might be required to ensure that there are no fractures of the bones of the ankle. Anti-inflammatory medicines like ibuprofen can help with pain and swelling, but they can cause side effects like stomach irritation and kidney injury. You should consult a doctor before taking these medications.

Most children recover from an ankle sprain in a few days to a few weeks. If the pain and swelling persists beyond this short period, then further treatment may be required. A physical therapist or sports trainer with skill in ankle sprain treatment may be able to further reduce swelling and speed the recovery process. Typically, the child can return to sports once he or she has recovered from the initial pain and swelling without fear of recurrent injury. Simple ankle braces, found at your local drug store, can provide some stability and aid in the transition back to sports.

If the pain persists, or if the sprains continue, then formal physical therapy can help improve ankle stability and strength. The therapy for recurrent ankle sprains focuses on control of swelling, ankle and foot range of motion, muscle strengthening and the return of proprioception (brain's ability to sense the location of a joint in space without looking directly at the joint). Normal proprioception is very important to prevent ankle sprains, and it is often lost when an ankle sprain occurs, thereby making recurrent ankle sprains that much more likely. Prolonged immobilization (more than a few weeks) with a cast or boot is typically not helpful with routine ankle sprains and can actually slow recovery and the child's return to sports.

You should seek medical attention at any point along the progression of an ankle sprain from injury to healing if you feel that injury seems unusual, or if your child is not healing like you hope or expect. Pediatricians, family practitioners, orthopedic surgeons and physical therapists all have training in the diagnosis and treatment of ankle sprains.