Dozens of Israelis have sought medical attention in the past week with complaints of acute ankle pain, following the ongoing security situation and frequent rocket sirens across Israel.
Tests have shown that the majority of the reported injuries are sprains, typically caused by a sudden movement of the foot, often while rushing to shelters, hospitals, or other protected areas.
Some of the injured described twisting their ankle, while others reported a sudden “pop” sensation or their leg giving out during exertion.
A sprain is one of the most common injuries to the skeletal system. During times of heightened security, sprains happen more frequently.
But what exactly is an ankle sprain, how can we distinguish it from a fracture, and what are the key guidelines for proper treatment?
A sprain occurs when the ligaments surrounding and supporting the joint are overstretched or even torn. This typically happens when the ankle twists at a sharp angle—for example, when a person missteps while running.
Different types of sprains
The severity of an ankle sprain can totally vary.
A mild sprain involves minor stretching of the ligaments, slight swelling, and mild pain. However, a person with a light sprain can bear weight on the injured leg.
A moderate sprain involves partial rupture of one or more ligaments, accompanied by more significant pain, swelling, and bruising. It is usually more difficult to walk on this type of sprain.
A severe sprain means a complete rupture of the ligaments, which causes severe pain, instability of the ankle joint, and a complete inability to walk on the injured leg.
How to treat a sprain
If you’ve sprained something and aren’t sure if it’s a fracture or just ligament damage, the best way to start treatment is by following RICE (Rest, Ice, Compression, and Elevation).
First, give your leg some rest—no heavy activity or putting weight on it. Next, apply ice wrapped in a towel to the injured area for about 15-20 minutes every couple of hours. This helps with both pain and swelling. You’ll also want to wrap it with a light elastic bandage to keep the swelling down. And finally, elevate your leg when you can, as this will help prevent fluid buildup and reduce swelling.
However, it is important to know when to seek medical attention. According to orthopedists, if the pain is severe, if the leg cannot bear weight, if there is visible deformity in the ankle, or if there is extensive bleeding, the injury could be a fracture.
In such cases, seek immediate medical care at an emergency room or urgent care center for a full examination. An X-ray is the primary tool used to rule out or confirm an ankle fracture.
Sprain versus a fracture
There are several signs that can help differentiate between a sprain and a fracture: In a sprain, the pain is typically located on the sides of the ankle, and it tends to improve slightly with rest and ice.
In contrast, pain from a fracture is usually sharp and located directly over or above the ankle bone, and is often accompanied by a complete inability to step or move the foot. Rapid swelling, a popping or cracking sensation at the time of injury, or noticeable deformity of the ankle also warrant immediate medical attention.
In most mild to moderate sprains, the injury can be treated at home using the RICE method, along with over-the-counter pain medications like acetaminophen or ibuprofen.
During the first week, it’s important to avoid putting weight on the injured foot and rest as much as possible. Once the swelling and pain have subsided, gradual rehabilitation exercises should be incorporated to strengthen the ankle and restore its range of motion.
Preventing future injuries can be challenging: Research shows that people who have previously suffered a sprain are at higher risk of reinjury.
Therefore, it is essential to strengthen the leg muscles, particularly the calf and ankle muscles. Consider using an ankle brace during high-impact physical activities, and ensure that shoes provide ample support with stable soles, especially when running or descending stairs to a shelter.
Heightened stress contributes to these injuries
Rushing to a safe place in a state of heightened stress also contributes to these injuries. The body is under tension, and people often move quickly without paying attention to their surroundings, such as stairs, obstacles, or uneven surfaces.
This increases the likelihood of accidents. While a sprain is not life-threatening, it is often painful and can restrict movement for about a week. In more severe cases, it may require intensive medical treatment.
Bottom line: Evacuate to a protected area quickly but carefully.