SPRAINED ANKLE CAUSING KNEE PAIN?

Alternatively, the accident that led to your sprained ankle might not cause any immediate direct injury on the knee, but the incomplete recovery of the ankle joint movement can put the knee joint under extra pressure triggering problems in this structure. Another common situation is for the pain the appear in the non-injured leg. This is due to a compensation process where unconsciously you remove the weight from the injured leg putting extra pressure and unnatural movements on your good leg, to protect the injured one.

Once you start experiencing knee pain, it means the knee structure is somehow damaged and the joint can no longer ensure its main purpose: stability. If you continue to push yourself ignoring the signals you will start damaging the next joint: the hip.

What is a Sprained ankle?

A sprained ankle occurs when you roll, twist or turn your ankle in an awkward way. This can stretch or tear the ligaments that help hold your ankle bones together.

When your ankle suffers an injury and it moves outside of the normal range of movement, these ligaments are overstretched and suffer lesions that can vary in severity from micro-tearing to complete tearing of the ligament. This lesion triggers an inflammatory reaction that many times can be seen as a swollen ankle. This is the body process to call the necessary cells and mediators to the injury region to try to heal the lesion. Most of sprained ankles are associated with injuries to the ligaments on the outer side of the ankle.

The ankle sprain is a very frequent injury, in US alone there are approximately 2 million reported cases per year. The most common cause of a sprained ankle is walking or landing on an uneven surface promoting the twist of the foot. Ankle sprains are usually classified into 3 grades: Mild, Medium and Severe.

The common symptoms of a sprained ankle are local pain, swelling of the region and limited mobility of the ankle.

How to recover a sprained ankle or knee?

Depending on the severity of the injury, the time to recover will vary greatly. Most ankle sprains will recover in 2-6 weeks, but more severe injuries can take 4-6 months for complete recovery.

You should consider checking in with your physician if you have:

· a swelling that is tender to the touch;

· a bruising around the ankle or foot;

· a restricted range of motion

· pain and cannot bear weight on the injured foot;

· heard a popping sensation or sound at the time of the injury.

Treating your acute sprained ankle should focus on controlling the swelling. The swelling should disappear after a couple days. In case it does not improve it is a clear signal to consult your physician for more detailed assessment.

The initial treatment is important to relieve the pain and to recover your mobility, but the full recovery is equally important to prevent chronic pain and instability in the ankle and knee joints.

The recovering of an ankle sprain should ensure the following:

· restore normal joint functionality;

· restore ankle natural range of motion;

· ankle strengthening;

· prevent weakening of associated muscle groups like calf and gluts.

The recovery usually consists in 3 phases:

R.I.C.E.

The first phase can be described using the acronym R.I.C.E.:

Rest – minimize walking and use crutches if necessary.

Ice – apply ice wrapped on a thin cloth for 15 minutes to minimize the inflammation. Repeat over the day for periods of 15 minutes.

Compression – apply a bandage to the injured ankle. This will provide a bit of structural support to compensate the damaged ligaments and at the same time help to contain the swelling.

Elevation – find a comfortable position to elevate the ankle above waist or heart level. This will reduce the swelling.

This is the initial recovery phase that can take from a couple days up to a week. The main purpose of this phase is to control swelling and rest the ankle so that it begins to heal.

Restore flexibility and range of motion

In the days following the injury, once the swelling and pain starts to decrease you should start doing gentle movements. These should be done within the range of no pain! Do not stretch the ligament beyond the comfort zone to avoid worsening of the injury.

Common exercises are to gentle point and flex the foot to promote the joint motion. Over the days the range of motion you can do without pain should increase.

It might be useful at this point to consider the help of a physiotherapist to guide you in the process to fully recover the flexibility of the ankle and prepare the strengthening of the joint tissues as well as affected muscles.

Restore strength and ensure functional balance to prevent other injuries.

Once you are painless and you have recovered the mobility in the ankle, you might feel that this injury is fully recovered and carry on with your normal life. You should however be aware that the injury has left your ligaments and joint weaker than before. This weakening can also extend to associated muscles like calf and gluts. This situation makes the ankle and related joints more susceptible to future injuries, which tend to be more serious.

Therefore, it is crucial to ensure the ankle strengthening and prevent weakening of associated muscle groups like calf and gluts. This will safeguard this concrete ankle but also avoid damages to both knees.

There are 2 exercises that will help you achieve this and are quite simple:

· Balance on one foot for 30 seconds at a time

· Toe raises: 3 sets of 10-20 repetitions

These exercises will help you gain balance and strengthen the joint, as well as the associated muscles. While doing these exercises, you shouldn’t fill pain since the ligaments should be recovered and joint mobility restored. In case you experience pain, it means one of the previous steps is not yet fully completed. Do not rush through the process, be patient and ensure you have fully recovered the mobility and that the ligament is ready to be strengthened prior to start these exercises.

A full recovery will ensure that you are ready to go back to your normal life, including playing sports. You can consider using the banding supports to give you more comfort while doing sports, but this should not replace this crucial step of the recovery. If not done properly, with or without banding supports, it will be a matter of time until you come across a related injury again.

How does a sprain ankle affect the knee?

It is not uncommon to suffer knee injuries when you suffer from an ankle sprain. When these lesions are minor, they are many times overlooked since the focus is on the ankle, the origin of the major pain. During the ankle recovery process, the knee will also be somehow safeguarded from strong movements and for this reason many of us only realize that there might be something wrong with the knee once the ankle sprain is recovered and painless.

Alternatively, there are cases where the knee is injured not directly by the cause of the ankle sprain, but rather by the incomplete recovery of the ankle joint. When this happens, the mobility function that the ankle joint was supposed to ensure is transferred to the knee joint. The problem is that the knee joint main role is stability and not mobility, so the knee joint structure is not prepared for some kind of movements and pressures that will come from a not fully functional ankle joint. This can happen in the same leg of the injury or on the opposite leg.

Once you return to your normal life you might come across:

· pain in the knee after a twist;

· pain with movement or activity in the knee;

· swelling in the knee;

· walking with a limp or realizing the knee cannot stand the weight while standing and walking.

These are symptoms of a sprained knee.

As soon as experience discomfort or pain in the knee you should pay attention to it. A minor injury in the knee will quickly progress if you keep stressing it.

If you have suffered from a sprained ankle and now you are starting to have knee pain, seriously consider investing your time in making sure that the ankle is completely recovered and functionally at 100%. Work on the ankle mobility and strengthening before you put too much stress on the knee.