Preventing Ankle Injuries in the Winter

Icy conditions are an inevitable part of winter in Canada – purposefully created and strategically placed ice is great for sports and activities like hockey, skating, and curling. However, it is not so great when the ice patches are unsuspecting and take your feet out from under you. When someone slips on ice, the natural instinct is to try to catch yourself before you fall. This can sometimes be successful in completely avoiding injury. The not-so-lucky end up twisting their ankle, placing excess stress on a part of the foot or ankle, and/or falling anyways, leading to a sprain or fracture of the lower leg.

What is the difference between a sprain and a fracture?

A sprain occurs when a ligament (soft tissue) is stretched beyond its limit, causing it to tear. The severity of a sprain can range from mild (small tear in some of the ligament fibers) to severe (complete tear of all of the ligament fibers). Most mild sprains can be treated with at-home remedies such as rest and ice, whereas moderate and severe sprains might require medical intervention. Without proper care and rehabilitation, this can lead to chronic issues. In the ankle, there are four ligaments that provide stability, with the most commonly injured being the ligaments that run along the outside of the ankle.

Common symptoms:

  • Pain
  • Swelling
  • Bruising
  • Tender to touch
  • Limited ability to weight bear
  • Stiffness
  • Instability

A fracture occurs when there is a break or chip in the bone. The ankle joint is made up of three bones, while the foot is made up of twenty-six bones. One or more of these bones can break, leading to varying levels of pain and debilitation.

Common symptoms:

  • Immediate and severe pain
  • Persistent pain
  • Swelling
  • Bruising
  • Tender to touch
  • Limited to no ability to weight bear
  • Deformity

How can you tell the difference between a sprain and fracture?

As you can see, many of the symptoms of an ankle sprain and fracture are very similar. As well, what happens when you fall can also be very similar, making it difficult to determine if you have sprained or fractured your ankle.  In some cases, you may not be able to walk or bear weight at all with symptoms starting immediately. In other cases, you might be able to put some weight through the ankle with pain or discomfort. Sometimes, the pain and symptoms don’t occur until a day or two later.  In all situations, it is best to seek medical attention. An X-ray is the best way to determine if there is a fracture or not.

Treatment and Recovery

Once you have determined the injury, treatment and recovery might differ depending on the severity of the damage.

  • For a sprain, treatment may consist of rest and ice, a brace to provide stability, a boot walker to immobilize the joint, or in severe chronic cases that do not respond to non-surgical treatments, surgery can be done to repair the ligament.
  • For a fracture, treatment may consist of a boot walker or immobilizer for the ankle and foot, a cast, or surgery depending on how bad the break is. A combination of the three is also possible.

A boot walker will almost always be beneficial in the treatment for a fracture and can help significantly with more severe sprains. The purpose of a boot walker is to limit ROM and forces through the foot and ankle to allow the bones or ligaments to heal. Depending on the stage of treatment, varying levels of weight bearing are permitted with a boot walker.

When looking for a boot walker, you want to look for something that is comfortable, light and low profile. They allow for the most natural gait when the heel is low and narrow and it has what is called a “rocker bottom”. This style of sole rolls the foot through a step, so that you can still bend your knee and flex your hip without moving the foot and ankle. All of these features are offered with the BREG Genesis 4- and 3- strap boot walkers.

The best treatment is prevention! So, how can we avoid slips and falls?

  • Walk slowly and carefully. Take precautions such as using your foot to test a potentially icy area before taking a step.
  • Proper footwear is vital! Wear boots with good tread or other slip-resistant footwear.
  • Use special care when getting in and out of your car. If you need to, use support, such as a vehicle or a walker.
  • Try to avoid carrying items or walking with your hands in your pockets. This can reduce your ability to catch yourself if you lose your balance.
  • Be cautious of black ice.
  • Avoid uneven surfaces when possible. Avoid steps or curbs with ice on them.
  • Be aware of your surroundings. Are there snow banks? A sewer grate or storm drain? A slope where water can pool and freeze at the bottom? Cars coming? (I remember one time my dad was standing on a curb waiting to cross the street and a car came flying by. He had to jump back and landed on an icy slope and sure enough, he broke his ankle).

Take precautions and be careful but remember Arthritis and Injury Care is here to help you through your injury!

How Can We Help?

At the Arthritis and Injury Care Centre, we strive to help patients on their journey and provide them with the education and support they need. If you or a loved one would like more information on how we can help, please contact us for an opportunity to meet with one of our staff.

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