Michelangelolaan 2
5623 EJ Eindhoven

040 - 239 91 11

Ankle distortion (Folder)

Twisted ankle, ankle sprain

An ankle distortion or twisted ankle is often the result of twisting or overextending your ankle in an awkward way. Symptoms include pain, bruising and swelling of the ankle. This type of injury is treated at the emergency department and you will be discharged afterwards. You can read more about your injury and what you should do in the coming days in this pamphlet. 

Summary

• You have sprained your ankle as a result of an awkward movement, and the ligaments of your ankle have sustained a partial tear.
• This type of injury almost always heals well without any loss of function.
• A routine follow-up is not necessary for this type of injury.
• The pressure bandage that you received at the emergency department will support your ankle, but does not contribute to the healing process of this injury.
• Walking will result in a faster recovery, try to walk as soon as your pain allows this.
• Try moving your ankle frequently to prevent stiffness. Biking is a good way to practice the movements of your ankle.
• You can find exercises for your ankle in this pamphlet or in the app in the App store (iPhone) or Google Store (Android). See QR-code at more information online.
• If you have any questions, or are experiencing problems with your recovery, you can call the “breuklijn” (fracture hotline (+31) 040 239 96 40 on workdays between 9.00 and 12.00.

Treatment

After a sudden awkward movement, your foot can twist to the inside or outside. This is called a distortion, sprain, or twisted ankle. The ligaments of you ankle will be overstretched and may sustain a partial tear. Full-length tears of ankle ligaments are extremely rare. This partial tearing can also result in ruptures in some of the smaller blood vessels, which causes bruising. After a distortion, swelling may also occur, usually on the outside of the ankle.

What can you do if you have an ankle distortion?

Follow these instructions for a good recovery.

• Avoid awkward movements with your ankle, for example, by using crutches. Crutches can be bought at the hospital. Depending on your situation, you will get a pressure bandage or elastic sock (called atubigrip).
• A pressure bandage will support your ankle, but does not accelerate healing. You can leave the bandage on for 3-5 days. The elastic sock should be removed when taking a shower and at night.
• Walking will improve your recovery, so try walking as soon as you are able. Try to keep your foot straight when walking to avoid twisting it again. If walking makes the pain worse, stop, and try again the next day.
• Avoid stiffness of the ankle by moving your foot regularly, even when you are sitting or lying down.
• Elevate your foot to reduce swelling and pain. Your foot should be above your knee, and your knee should be above the level of your hips. You can put a pillow underneath your mattress to achieve this.
• Cooling can reduce pain, but will not reduce swelling. You can cool the ankle with ice in a plastic bag or by using an ice-pack. Wrap the ice in a cloth to avoid frostbite of your skin.
• Cycling is an excellent way to practice moving your ankle.
• Be extra careful when practicing sports that have a high risk of twisting your ankle, such as field sports.

Please note that in the Netherlands, you are not insured when driving a vehicle while wearing a pressure bandage or tubigrip.

When will your ankle be re-examined?

Because of the swelling, thorough physical examination of your ligaments is not possible during your visit at the emergency department. This can be done after 4-7 days, when the swelling has decreased. You should make an appointment with your general practitioner for the follow-up examination of your ankle ligaments. In some cases, we will make an appointment in the hospital in the outpatient clinic.

How long will your recovery take?

Overstretched ankle ligaments

• Overstretched ligaments will heal well over time. For the first couple of days, your ankle may be painful and swollen. After 3-4 days, the pain will gradually decrease and you will be able to put weight on it again. You will no longer need crutches.
• After a few days, the swelling will be reduced. It is common for the heel of your foot, the outside of your foot and your toes to become blue due to the bruising. In a later stage, this color will change to green and yellow and eventually disappear.
• You are usually able to resume all normal activities within 2 weeks, including sports.

Partial tear of the ankle ligaments

• A partial tear of the ankle ligaments will heal well over time. Recovery takes slightly longer than it would take for overstretched ligaments. It will take at least 2 weeks before you can resume walking and cycling. You can use crutches in the meantime. It can take several months before you can resume sports.
• A partial tear is treated with a special tape or ankle brace, but only after the swelling has gone down. You can make an appointment with your physiotherapist or general practitioner to do so.
• When you ankle has almost fully healed, it is common that there is some swelling around the ankle after certain activities such as walking. This is normal and not harmful. You do not need to refrain from these activities if this happens.

When should you contact your general practitioner?

• If the swelling and pain do not improve after 4 days.
• If you still have complaints after 4 days and the swelling has gone down.
• If you need more pain medication.

Excercises

After a distortion of the ankle, stiffness, loss of strength and loss of coordination may occur. The following exercises can be performed to support your recovery

When to start and what to do

It is important that you start exercising immediately as much as possible, if the pain allows it. This will prevent the ankle from becoming stiff. Start with non-weight bearing exercises, which are exercises you do without standing on the foot. Then start with weight bearing exercises. Exercise only when the pain allows it.

Follow the instructions below:

• Perform the exercises at least 3 times per day
• Repeat each exercise 10 to 15 times
• Build up gradually, taking rest if necessary after doing exercises by putting the leg back up high.
• you can perform the exercises in warm water if preferred

1. Place your foot far from the chair and try to place your heel on the ground.	2. Slide your foot closer to the chair and try to put your heel back on the ground. Pull your foot closer until you feel a mild-moderate stretch.

Active exercises: stand up and do the stretching exercises using your body weight, as shown in the pictures below.

1. Place your healthy foot in front. Stretch your injured ankle as far as possible.	2. Place your injured foot flat on the ground.

3. Place your healthy foot behind your injured foot.	4. Stretch your injured ankle as far as possible.

Other exercises: it is important to practice standing correctly on the affected leg, as pain allows. Walking starts with being able to stand on one leg. Also try to use the ankle as normally as possible again, as pain allows. Every step you take is a step closer to a normal gait.

Questions? Please call us!

If there are any questions after reading the information, please contact the Breuklijn at 040 239 96 40 between 09.00 and 12.00.

In case of an emergency or problems that cannot wait until the next weekday, please contact our emergency department at 040 – 239 96 00

Contact

Catharina Ziekenhuis Eindhoven
040 – 239 91 11
www.catharinaziekenhuis.nl

Breuklijn (Fracture hotline)
(+31) 040 239 96 40 (on workdays 9.00 – 12.00h)

Route numbers and other information about our emergengy department can be found at: www.catharinaziekenhuis.nl/spoedeisende-hulp

App Virtual Fracture Care

In our app you can find more information about your injury. You can also find exercises here to improve your recovery. You can find the app in the Appstore (iPhone) and in the Google Store (Android).

You can also scan the QR-code. You will then automatically be directed to the app.