What to do if you twist your ankle and it hurts | Hello

Dislocations , sprains , bruises and ruptures (of ligaments, for example) are injuries that damage muscles and joints.

Such injuries are common companions for people who lead an active lifestyle and play various sports. Often the cause of these injuries is a person’s unpreparedness for a given physical activity - which is why it is recommended to specially prepare for each sports achievement.

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Treatment of dislocations, sprains, ligament tears

2 Treatment of dislocations, sprains, ligament tears

3 Treatment of dislocations, sprains, ligament tears

However, dislocations, bruises, sprains and ligament tears can also be caused at home. Dislocations of the shoulder and knee joints are most often recorded. A dislocation of the ankle joint, for example, is much less common (usually this is an injury to lovers of high-heeled shoes).

Let's try to figure out how to properly treat dislocations and other injuries.

Symptoms of dislocation

Depending on the type of injury, be it, for example, a dislocated hip, a dislocated leg, or a dislocated shoulder, the manifestations of the disease may differ from each other. So, with a similar problem with the hip joint, received at birth, the gait is often disturbed, the posture is bent, and one leg may even become shorter than the other.

However, there are still general symptoms of dislocation, based on which one can assume a dislocation of a certain part of the body:

• redness of the skin in the affected area;
• intense pain that intensifies when moving the dislocated limb;
• external change in the shape of the joint, an increase in its size;
• increased swelling in the injured area;
• loss of sensation in the limbs (this symptom is possible due to injury to nerve endings);
• difficulty in motor activity;
• increase in body temperature, high fever, chills.

Sprains

Sprains occur in a person if he performs sudden movements with a force exceeding the permissible load on the joint. When a ligament is sprained, there is partial damage or incomplete rupture of the capsule of the ligaments that strengthen the joint.

The ligaments most often affected by sprains are the ankle ligaments (especially when the foot rolls in) and the wrist joint. Somewhat less commonly, this injury affects the ligaments of the knee joint. When wearing high-heeled shoes, a woman often gets her legs turned inward and the Achilles tendon stretched.

Degrees of sprain

The following degrees of ligament damage can be distinguished:

• 1st degree , preservation of the mechanical integrity of the ligament with rupture of individual fibers. The presence of slight edema without hemorrhage is characteristic. The patient may feel moderate pain, with limited movement and support;
• Grade 2 , accompanied by partial damage to the articular capsule of the ligaments, the appearance of multiple fiber ruptures, frequent blood loss and moderate swelling. Difficulty in support, movements are quite painful and limited. Some instability of the joint is revealed.
• Grade 3 , complete rupture of the ligaments, which is marked by severe pain, significant swelling and bruising. When moving, joint instability is felt.

For grade 1 and 2 sprains, conservative treatment may often be sufficient.

For complete ligament ruptures, surgical treatment is used.

Causes

The main cause of dislocation, whether it is a dislocation of the shoulder joint or jaw, is indirect trauma. So, for example, if a person accidentally falls directly on his hand, stretching it forward, then, most likely, it is not the hand itself that will suffer, but his shoulder joint.

Often, damage occurs along with a number of severe bone diseases, as additional complications. These include:

• tuberculosis;
• arthritis;
• osteomyelitis;
• arthrosis and others.

Ligament tears

Ligament rupture is a fairly common type of injury for people whose work involves prolonged physical activity. Most often, ligament rupture accompanies a dislocation or fracture, but it can also be an independent injury.

In accordance with the reasons that caused the injuries, traumatic and degenerative ligament ruptures are distinguished. If the first type of damage can be obtained as a result of injuries, then the second occurs during the aging process of the body.

Symptoms of ligament rupture:

• pain and limitation of joint function (impossibility to straighten and lift the injured arm or leg);
• the appearance of edema, hematoma;
• change in the external contours of the damaged joint (joint instability);
• the occurrence of numbness and tingling in the affected limb.

A special place is occupied by ligament ruptures such as meniscus damage.

When should you see a doctor?

If you suspect you have a dislocated hip or dislocated hip joint, you should immediately seek qualified medical help. Otherwise, there is a risk of aggravating the condition of an already damaged joint.

It is necessary to provide first aid for a dislocation. The joint should be immediately immobilized and a cooling compress applied to it to reduce swelling. If the injured person feels unbearable pain, it is necessary to give him an anesthetic drug. Then you need to transport the victim to the hospital to provide him with proper medical care by an experienced trauma surgeon.

Specialists with many years of qualifications and enormous work experience are ready to accept patients at JSC “Medicine” (clinic of Academician Roitberg) at any time. The multifunctional medical institution is located in the center of Moscow, at 2nd Tverskoy-Yamskaya Lane, 10, close to the Mayakovskaya, Belorusskaya, Tverskaya, Novoslobodskaya and Chekhovskaya metro stations.

Diagnostics

Photo: clearwaterphysio.com

A dislocation can be suspected based on the presence of a previous injury and the characteristic clinical picture. In case of a dislocation, a person will complain primarily of severe pain, the inability to make movements in the affected area, swelling and hyperemia of the skin in the projection of the dislocation, etc. During the examination, the doctor assesses the amount of active and passive movements in the affected joint. Active movements are performed by the patient at the doctor’s command. If there is a dislocation, the patient cannot follow the doctor’s commands, and his attempts are accompanied by increased pain. It is worth noting that movements reflect not only the condition of the joints, but also the muscles, fascia and tendons. The assessment of the condition of the joints also helps to study passive movements, which are performed with complete relaxation of the patient’s muscles, which excludes the participation of muscles and tendons in the movement. However, if there is an excessive range of motion, they speak of pathology of the muscles and tendons. In addition, it must be remembered that passive movements must be performed within the limits of physiological capabilities and stop when pain occurs. In the presence of a dislocation, there is an inability to perform passive movements in the affected joint, and there is also some springy resistance that occurs due to spasm of the skeletal muscles in response to the dislocation of the joint.

Next, an X-ray examination is performed to make an accurate diagnosis. This diagnostic method is affordable and easy to use. The detection in the image of a violation of the spatial interaction between the main components of the joint (articular head and socket) confirms the presence of a dislocation. In this case, the articular cavity looks deserted, and the head of the joint is located away from the cavity. If partial contact of the articular head with the socket is maintained, when only partial displacement of the head occurs, they speak of incomplete dislocation. The only drawback of the X-ray method for studying dislocations is the inability to obtain information about the condition of the ligamentous apparatus, nerve and vascular trunks and muscles.

In some cases, especially with complicated dislocations, studies such as CT or MRI of the joint are required. CT (computed tomography) of the joint is a highly informative study that allows you to take high-resolution images with maximum accuracy. The examination does not require any prior special preparation from the patient, is performed within 1–2 minutes, and is safe for people with implanted metal structures. MRI (magnetic resonance imaging) allows you to evaluate the condition of not only bones and joints, but also the surrounding soft tissues, which makes this study more informative. In addition, MRI is considered the safest research method, due to which it can be prescribed even to pregnant women and newborn children.

If numbness, tingling, a sensation of “crawling” on the skin, or decreased sensitivity in the affected area occur, there is suspicion of compression or damage to the nerve plexus and blood vessels. In this case, consultation with a neurosurgeon and vascular surgeon is necessary.

Treatment of injury

It includes mandatory repositioning of the displaced joint and returning it to its previous position. The manipulation can be performed under both general and local anesthesia. Finally, a plaster cast is applied to the damaged area.

In addition, there is often a need for additional procedures:

• therapeutic massage;
• recreational gymnastics;
• acupuncture sessions.

In particularly difficult situations, surgery may be indicated. If the cause of the dislocation is a bone disease, you should definitely give it due attention and carefully treat it, otherwise the injuries will recur again and again.

Treatment of joint dislocations and reduction

Treatment of traumatic dislocations consists of reduction (relocation) and fixation of the articular elements. This procedure should be carried out immediately if the patient is in satisfactory condition.

If the dislocation is not corrected as soon as possible, this can lead to a number of complications:

1. development of contracture due to contraction of muscle fibers;
2. the formation of scar tissue in the joint cavity - usually at the site of a dense blood clot (fibrin).

There are two options for joint realignment:

• open;
• closed.

The open method is used if the closed method is contraindicated for medical reasons. Its essence lies in joint arthroscopy. Through surgery, the doctor removes from the joint cavity coagulated blood and articular elements destroyed due to injury. He then returns the displaced parts to their original position using lever-like movements. This is a painful procedure, so it is performed under general anesthesia. Anesthesia allows not only to achieve pain relief, but also has a relaxing effect on muscle fibers, facilitating the operation.

The closed method involves returning the articular heads to their place without surgical intervention. After reduction, the joint must be immobilized. To do this, a plaster fixing bandage is applied to it for 14–20 days. After reduction, a control x-ray is taken, which shows whether the displaced structures are in the correct position.

Rehabilitation after injury

After the dislocation has been treated at the proper level and the patient has gone home with the doctor’s recommendations, the recovery period begins.

In order to strengthen muscles and bones and quickly return them to their previous condition, it is recommended:

• take a course of restorative massage;
• physical therapy course;
• take up regular swimming;
• do not avoid long walks in the fresh air;
• balance your own diet by consuming enough proteins, fats and carbohydrates required by the body.

Prevention of dislocation of the shoulder joint, jaw or other part of the body consists, first of all, of taking good care of your own health, proper nutrition and regular exercise.

Meniscal tears

The menisci of the knee (internal and external) are a kind of cartilage pads between the bones that protect the articular cartilage and ensure smooth movements when walking.

A meniscus tear is a damage to the cartilage formation, which is accompanied by injury to the structures of the knee joint. Injuries such as cruciate ligament injury and rupture of the collateral ligaments (the lateral ligaments of the knee) often occur simultaneously with a meniscus tear. Meniscal tears are common among athletes, especially representatives of contact sports.

The second reason for damage to the meniscus of the knee joint is degenerative disorders in cartilaginous formations. If the meniscus is damaged, the function of the entire joint deteriorates, pain, swelling, cracking and popping appear when bending the knee.

1 Treatment of dislocations, sprains, ligament tears

2 Treatment of dislocations, sprains, ligament tears

3 Treatment of dislocations, sprains, ligament tears

What is not recommended to do

If we are talking about how to minimize unpleasant consequences and prevent possible complications during treatment at home, then the following rules should not be neglected. For this it is important:

1. Refrain from hot baths at least in the first days after injury: hot water accelerates blood flow, which increases inflammation and swelling in the damaged area.
2. Reduce motor and physical activity, overcoming pain: this way you can cause even more harm to the diseased joint.
3. You should not massage the area next to the injury: this will increase blood circulation, which will result in swelling, and in some cases, bruising may occur.
4. Try to avoid too long rest or rest - for the first couple of days it is advisable to refrain from sudden movements and active movements, and already on the third day after a sprain or bruise, you can gradually increase the load (lean on the injured leg), but in the case of fractures or dislocations, the methods and timing of healing Only the attending physician can advise on injuries.

If you follow these simple rules, you can prevent negative consequences from injury, and for preventive purposes, when complete recovery occurs, doctors recommend using comfortable shoes with orthopedic insoles.

Prevention of an injured ankle

Ankle joint injuries are insidious - they will constantly remind you of themselves, once you sprain your ankle: a person is constantly at risk when playing sports, wearing the wrong shoes or making awkward movements. In order to prevent undesirable consequences, it is necessary to follow preventive measures:

1. Select and wear comfortable, high-quality shoes that match your foot size and are comfortable when walking (it is advisable for women to prefer low-heeled shoes, because stylish stiletto heels increase the risk of re-injury).
2. Strengthen the muscles of the ankle joint (this can be done with the help of special exercises).
3. When starting to play sports, it is important to warm up in order to warm up your muscles well before the upcoming load.

The main thing to remember is that staying alert and careful is the first rule to avoid sprains and/or serious ankle problems. After all, as follows from the complaints of victims, in most cases, ankle injuries occur precisely because of elementary inattention: people often do not look at their feet. It's corny, but true.

Procedure for an ankle injury

The first thing you need to do if you twist your ankle badly is to concentrate on your own feelings, listen to yourself. If everything is in order, the pain goes away on its own within 20–30 seconds. After the condition has returned to normal, you can continue moving.

What to do if you twist your ankle, but it hurts a lot, and there is no relief? Continue observation. If a limb aches, it needs rest for at least one hour. If, after twisting your leg, you feel severe pain when touched, bruising or swelling occurs, it is advisable to contact a medical facility. All of these could be signs of serious problems. What other symptoms of a sprained leg indicate that a doctor’s help is needed:

• atypical joint mobility;
• ankle instability, when the foot involuntarily changes its position when running or walking;
• visible bone deformation;
• persistence of pain during the first day;
• inability to stand on the injured limb even several days after the incident;
• ankle swelling;
• the appearance of bumps;
• loss of sensation in the foot (complete or partial, when, for example, the fingers or at least one of them go numb).

The traumatologist collects anamnesis, performs a visual examination and palpation. If this is not enough to clarify the diagnosis, the doctor will refer you for an X-ray, CT scan or MRI. Additional studies should exclude more complex injuries: fractures, dislocations. Self-treatment, much less realignment of a joint or bone, is unacceptable.