Out walking, on the playing field or tennis court, you fall and hurt your ankle.

Annoying and painful, definitely. But now what? Feet up on the couch or off to A&E?

Fracture or Sprain?

These 4 quick tests, called the Ottawa Ankle Rules, are designed to eliminate people who do NOT have an ankle/foot fracture and thus, do not need an x-ray!!

1. Can you take 4 steps (limping is allowed!)? NO – get an X-ray
2. Do you have tenderness/pain around your medial or lateral malleoli (the little bone bumps on either side of your ankle)? YES – get an X-ray
3. Do you have tenderness/pain around the base of the 5th metatarsal (bump on the outside edge of your foot below your little toe)? YES – get an X-ray
4. Do you have tenderness/pain around your navicular bone? (bump on the inside of your foot, underneath your ankle crease)? YES – get an X-ray

There is an explanation and video via some awesome American specialists here. 

Results

Just because you can’t take 4 steps or you are tender in these places does NOT mean you definitely have a fracture – just that it’s worthwhile checking.

Remember that it is hard to see strained ligaments so X-rays (and MRIs) are looking for something broken. If it’s not broken then RELAX! Go home, rest the foot for 24 hours and apply ICE and check it out with a physio tomorrow

What Next?

Get support – a physical support / brace can help keep you mobile and, most importantly, stop you limping (which causes all kinds of problems later on). Always make sure your support is chosen and fitted by a professional.

Get treatment – some physiotherapy will help to ease the pain and inflammation and Magnetic Resonance Therapy (MRT) can help to strengthen and regenerate the ligaments for more serious injuries.

Prevention – a review of your footwear and small adjustments to your training routine, including more balance work can prevent a recurrence.

It might be “just” a sprain but ankle injuries affect how you walk and recent studies are showing that they can have a profound influence on many other aches and pains as we get older. So getting some treatment straight away can prevent needing a whole lot more in a few years.