BRACE YOURSELF; PUTTING SPRING BACK IN YOUR STEP AFTER A SPRAIN REQUIRES TIME.

Byline: Evan Henerson Staff Writer

Medical journals call it an ``inversion.'' Patients simply say ``sprained ankle.'' That's when they're not saying, ``Yeeeowwwch!''

About the only good thing to be said about the common and quite painful sports injury known as a sprained ankle is that nobody has ever died from one. The injury occurs most frequently by unnaturally rolling your foot beyond what the ligaments holding the foot bones together can take. Ankle sprains are especially common in sports like basketball and soccer where players do a lot of jumping, twisting and cutting.

You can be at the top of your game, in the best shape of your life, but if you land wrong, whether on the basketball court or simply by stepping off a curb, then it's Snap! Pop! Aaarrrgh! And you're out of action for anywhere from a couple of days to two months.

April has been a particularly nasty month for ankle sprains among Los Angeles athletes. On April 5, en route to leading his team to a victory over the Golden State Warriors, L.A. Lakers center Shaquille O'Neal sprained his left ankle, forcing him to miss two games.

Three days later, L.A. Dodgers All-Star outfielder Gary Sheffield sprained his right ankle while trying to chase down a double in a game against the New York Mets. The injury knocked Sheffield out of the game, but he returned to the Dodgers lineup a few days later. Both athletes were luckier than Phoenix Suns guard Jason Kidd, whose season was ended by a fractured ankle - an injury more serious than a sprain.

Team doctors for both the Lakers and the Dodgers would not comment on their players' injuries, but orthopedists and physical therapists say that athletes often determine their own pain thresholds and may decide to return to work even before an injury is healed.

``If it's a mild sprain, they can go back once the pain has decreased to a level that's tolerable,'' said Dr. Daniel Kharrazi, of Kerlan-Jobe Orthopedic Clinic in Los Angeles.

The higher the grade of sprain, the longer it will take to heal and the more recovery time you'll need. A Grade 1 ankle sprain means you've stretched one or more ligaments (most commonly, the anterior talo-fibular ligaments on the outside of the foot). With a Grade 2 sprain, the ligament is partially torn. Grade 3 is a complete tear of ligaments away from the bone.

If you crunch your foot, but the ligaments holds up, the bone can break. Then you've got a fracture, which means an even longer recovery time - possibly even a cast and crutches.

Athletes won't necessarily concern themselves with matters such as grades, not when there are still games to be played, said Dr. Lauren Krieger, an orthopedist with Kaiser Permanente in Panorama City, who specializes in foot and ankle injuries.

``The problem with athletes is that there's such intense pressure to return them to work, that periods of time that would otherwise be spent in immobilization, or even casting, get overlooked or sidestepped,'' said Krieger, who emphasized that he was not referring to the regimens followed by Sheffield or O'Neal. ``We wind up putting them back into a stressful situation early.''

The rest of us don't face that kind of pressure and can take more time to baby ourselves. Time to heal and strengthening exercises, are what even the mildest sprained ankle needs most, according to doctors.

If an ankle injury is more than a tweak, and the pain isn't going away after a couple hours, see a physician - either a general practitioner or an orthopedist - to rule out the possibility of a fracture. In addition to stress testing - where a doctor presses on the ligament to determine if there is abnormal motion that would determine a tear - pro athletes get X-rays and/or magnetic resonance imaging (MRI) exams. The non-athlete will rarely get an MRI, said Kharrazi.

Doctors advise patients to follow the RICE regime: rest, ice, compression and elevation. Stay off your feet, especially during the first 24 hours following the sprain. Use ice on the area, compress it, and elevate to reduce the pain and swelling. An ankle brace may also help.

In addition to swelling, a torn ligament will often mean internal bleeding, causing your foot to bruise and change color. It won't look pretty, but the bruising will fade naturally over a week or so.

After resting, a set of strengthening exercises can help you get back in shape. They include flexing and stretching with rubber tubing wrapped around the injured ankle. The exercises should be continued even after the injury has healed.

Some athletes who have chronic ankle problems decide to have surgery to tighten up the ligaments and re-secure them to the bone. Rehab time from that procedure: three months, according to Krieger.

CAPTION(S):

3 photos, box

Photo:

(1 -- 2 -- cover -- color) SNAP, CRACKLE, OUCH!

Ankle injuries, like Dodgers left fielder Gary Sheffield's (left), can ground athletes or weekend warriors

(3) no caption (Ankle)

Gus Ruelas/Staff Photographer

Box: ANKLE SPRAINS

SOURCE: Sports-medicine.com

Bradford Mar/Staff Artist