From: pyuen@qualcomm.com (Patrick Yuen)
Subject: Re: Crutches--yes or no? (long)
Organization: Qualcomm, Inc., San Diego, CA
Distribution: usa
Date: Thu, 10 Sep 1992 17:35:41 GMT

In article <1992Sep8.210429.18749@b11.b11.ingr.com>, paul@the144.NoSubdomain.NoDomain (Paul Hebert) writes:
> 
> 
> QUESTION 1:  After a sprained ankle, should I proceed without
> crutches (limping in discomfort but not pain), or should I borrow
> my friend's crutches for a few days.  I have heard conflicting
> recommendations.  Some say to stay off it; others say that after a day
> or two I should use the ankle (standing, walking, .... not playing,
> obviously).
> 
> QUESTION 2:  Each day so far I have soaked my ankle in cold water.  For
> what period of days should I continue this?  Until the swelling is gone?
>  Only the first couple of days?
> 
> 
> 

I'm no doctor or anything, but I can tell you the treatment I am 
currently receiving for a really nasty sprain I suffered two and a 
half weeks ago  =(.  Summary: Severe level 2 sprain.  According to the 
orthopedic surgeon, x-rays negative (nothing broken or fractured.  All the 
doctors I have seen have been very surprised by this). Of the three ligaments on
the outer part of the foot, completely torn the middle and others partially 
torn.  I also had partialtears on the ligaments on the inside of the ankle and 
damaged tendons in the lower leg and calf (my friends told me they saw my foot 
turn to nearly 90 degrees! Ouch!).  

Status and treatment:  For a week, the entire foot and lower leg remained 
completely swollen and I could not put any weight on it.  I remained on 
crutches and used an aircast.  Treatment was the usual RICE (Rest, Ice, 
Compression, Elevation).  No heat.

At the start of the second week, swelling was down by half (still extremely
huge from my toes to mid calf) and I could put weight on it, but
still could not walk.  I started physical therapy this week, and 
they had me do this contrast bath:  3 minutes in ice water (50
degrees), 2 minutes hot water (100 degrees), repeat three times and end
with three minutes in cold.  3 times a day.  This is to increase the 
circulation to reduce the swelling.  Also, they did a lot of massaging 
and I had to do stretching to the limits of my range of motion 3 times 
daily.  I was to stay on crutches as long as I couldn't walk, but I had 
to go slowly and practice the walking movement to stretch out the foot 
and promote circulation (this movement wasn't easy for me due to the 
inflexibility).  I continued the compression and elevation as well.

Now after a week and a half of therapy (2.5 weeks total) I can finally 
walk without the crutches and the swelling is gone except for the lump
of scar tissue around the ankle.  I don't do the contrast bath anymore
and I don't have to do the compression or elevation either.  I do still 
have to wear the aircast and probably will for at least a couple more
weeks.  My exercises now concentrate on restoring flexibility (still 
bad) and strength.  If you want details on these exercises, just email me.  
The ankle is improving fast now that the swelling is gone, but I will be in 
therapy at least another week.  My therapist estimates another 4 weeks
before I can attempt to play.

In direct answer to your questions: (1) get off the crutches as soon as 
you can walk, but stay off the foot for at least a day first; (2) do the
RICE thing as long as there is swelling and try the contrast bath.

Well, sorry to use up so much bandwidth, but ankle sprains are obviously
a common injury to people on the net, so I hope that someone can 
apply some of the treatment I've been getting to their own injury.

Patrick Yuen
pyuen@qualcomm.com
>