Joint Preservation Blog

January 11, 2009

Sprained Ankle Discharge Instructions

torn ankle ligament

torn ankle ligament

As a doctor who has treated sprained ankles and had a severe sprained ankle myself, here are my sprained ankle discharge instructions for my patients:

1.  Stay away from anti-inflammatories if you can help it!  These medications, otherwise known as NSAID’s block inflammation which can make things feel better, but inflammation is the basis of all healing, so blocking it is ill advised.  Use Tylenol if need a pain reliever.

2.  To control the swelling you can use ice and elevation.  Elevation means bringing the ankle above your chest/heart.  Icing means that you keep an ice bag on the ankle until the skin goes numb and then you remove it.  Again, the swelling is there is bring healing cells, growth factors, and new blood supply, so control it when it gets uncomfortable, but realize that it is serving a purpose.

3.  Immobilization as tolerated.   This means stay off of it when it hurts, but animal studies of ligament and joint healing usually show that staying completely off the area for extended periods will reduce the quality of the repair your body is able to muster.

4.  A sprained ankle takes only 4-12 weeks to completely heal.  if you still have pain, swelling, popping, clicking or other signs of an injury that is too big for your body to heal, consider getting an MRI or other type of imaging.  If the ligaments are completely torn in half, you will likely need surgery.  If they are stretched or partially torn, consider an injection based procedure to enhance healing.  In my clinical experience, prolotherapy can usually help.  Other options include surgery (I wouldn’t recommend this for a partial tear), or having the doctor inject your own stem cells into the ankle ligaments to heal the tear.  Below are videos on the newer stem cell procedures:

December 13, 2008

Ligament Injuries in Elbow

There are several ligaments that help support the elbow and a host of tendons that also help support the joint.  The collateral ligaments are the main structural support and act like duct tape that holds the elbow together.  Ligament injuries in elbow are very similar to other areas such as the ankle.  They can be caused by repetitive use or trauma.   While many heal, some do not.  Surgery for this condition can be difficult, as sewing damaged ligaments may or may not result in a good physiologic reapir.  The problem is that many times, the repair will either be tighter or looser than the original.  If the repair is not at the right physiologic tension, then the joint can be beat uo by the extra force and degeneration in the joint can increase.  I have several patients that are young and in this category.  They had a ligament repair that regrettably ended up too tight and now in their 20’s and 30’s the joints are wearing out. 

Is there a better way to treat a partial elblow ligament tear?  Yes, injecting the patient’s own stem cells into the ligament tear can help that ligament heal.  This way, the body sets the right level of tension in the ligament, more like a natural ligament repair.  For more information on this new procedure, see the link above.

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