Ankles provide support and stability for body every time a person stand, walk, or run. Because of their key function and the weight they support, your ankles are susceptible to overuse and injury [1].

Most people experience pain in and around their feet or ankles at some point in their lives. It’s one of the most complex, hard-working regions of your body. It has 26 bones and 33 small joints, all held together by a network of soft tissue made up of muscles, tendons, ligaments, nerves and blood vessels [2].

Most cases of foot or ankle pain are short term and are caused by soft tissue injuries, such as sprains or strains. These should gradually heal with the help of simple self-care measures. Though some could take a few months to fully recover, you probably won’t need to seek treatment from a healthcare professional [3].

A number of studies conducted in different parts of India reveal widespread ignorance about the ankle pain among people. As this disease largely relies on prevention and the right information at the right time is essential to bring about a behavioral change when the population is most receptive. Hence, this study was undertaken with the objective to assess the knowledge about preventive factors and practices during ankle pain among Ortho OPD patients in civil hospital Rohru.

Objectives of the Study:

• To evaluate the knowledge of patients attending Ortho OPD towards Prevention of ankle pain in civil hospital Rohru

• To evaluate the practices of patients attending Ortho OPD in civil hospital Rohru on having ankle pain

• Research approach -descriptive

• Research design-descriptive survey design

• Setting of the study- Ortho OPD of civil hospital Rohru

• Study duration- between Aug- December 2020

• Study population-Ortho OPD patients in civil hospital Rohru

• Sample size-400 Ortho OPD patients

• Sampling Technique-convenience Sampling technique

• Sampling criteria-first five patients attending the Ortho OPD of civil hospital Rohru everyday were selected till the completion of sample size after explaining the purpose of the study. Informed consent/assent was taken from them and confidentiality of the selected participants was also maintained 

• Inclusive criteria-patients selected during the day of data collection in study setting and who were willing to participate in the study

Exclusion Criteria

Patients who were not willing to participate in the study. Development of tool-knowledge related questionnaires.

Description of Tool:

• Section A-Socio-demographic characteristics of the patients (age, gender etc.)

• Sections B-Questions regarding knowledge of preventive factors for ankle pain and practices of patients in case of ankle pain

• Validity of tool-by the experts in this field

• Permission- obtained from the concerned head of the civil hospital

Data Collection

Data collection by myself and patients was given 5 minutes time to complete that questionnaire and collected at the end of the prescribed time.

Data Analysis

Data analysis with appropriate statistical test in terms of frequencies, percentage, mean, standard deviation. P value of less than 0.05 was considered to be statistically significant.

The present study was non-experimental descriptive study carried out to evaluate knowledge of preventive factors for ankle pain and practices of patients in case of ankle pain in civil hospital Rohru. 

In the present study 35% (140) of the patients fall were below 40 years of age while 65% (260) were above 40 years. 54% (216) of patients were male and 46% (184) were female.

Among the total patients maximum 347(86.75%) replied that avoiding sandals and shoes that are too loose helps in prevention of ankle injury or pain followed by minimizing wearing high heels 345(86.25%), wearing supportive shoes 324(81%), maintain weight 309 (77.25%), avoid running or stepping on uneven surfaces 302 (75.5%), abnormal gait while walking 301(75.25%), wear shoes according to activity 290 (72.5%), calcium and vitamin D supplements 278(69.5%), Wear proper footwear when playing sports 249(62.25%), exercise of ankle regularly 246 (61.5%), avoid prolong standing 245(61.25%), maintain good posture while standing 234 (58.5%), warming up before you play sports or exercise 178 (44.5%), avoid heavy lifting 134(33.5%) and eat healthily and balanced diet 123(30.75%). Among the total patients, 57(14.25%) didn’t know anything about prevention of ankle injury or pain (Table 1).

Table 1: Knowledge of patients towards prevention of ankle pain

Table 2: Practices of patients in case ankle pain

Among the total patients maximum 339(84.75%) replied that they applied of pain relief gels upon ankle pain followed by compression and wrapping with elastic bandage 334 (83.5%), rest the ankle 322 (80.5%), specific and correct type of footwear 303 (75.75%), avoid putting weight on ankle 302(75.5%), pain relief medications 290(72.5%), calcium and vitamin D supplements 290(72.5%), warm foot bath 289(72.25%), cold applications 289 (72.25%), heat applications 202 (50.5%), Stretching exercises for ankle 201(50.25%), elevation of ankle 124(31%) and acupressure and acupuncture 89(22.25%) (Table 2).

Ankle pain refers to any type of pain or discomfort in your ankles. This pain could be caused by an injury, like a sprain, or by a medical condition, like arthritis. Ankle sprain is one of the most common causes of ankle pain, making up 85 percent of all ankle injuries. A sprain occurs when ligaments (the tissues that connect bones) tear or get overstretched [4,5].

Most ankle sprains are lateral sprains, which occur when foot rolls, causing your outside ankle to twist toward the ground. This action stretches or rips the ligaments. A sprained ankle often swells and bruises for about 7 to 14 days. However, it may take a few months for a severe injury to heal fully [6].

For immediate at-home treatment of ankle pain, the Rest, Ice, Compression and Elevation (RICE) method is recommended. These includes take a break from your normal activities. Avoid putting weight on ankle. Try to move as little as possible for the first few days. Use crutches or a cane in case of walk or move. Begin by putting a bag of ice on ankle for at least 20 minutes at a time, with 90 minutes between icing sessions. Do these three to five times a day for 3 days after the injury. This helps reduce swelling and numb pain. Wrap injured ankle with an elastic bandage, like an ACE bandage to reduce swelling. Don’t wrap it so tightly that ankle becomes numb or that your toes turn blue. Whenever possible, keep ankle raised above heart level on a stack of pillows or other type of support structure to help reduce swelling [7,8].

In the current study, among the total study participants, maximum 339(84.75%) replied that they applied of pain relief gels upon ankle pain followed by compression and wrapping with elastic bandage 334 (83.5%), rest the ankle 322 (80.5%), specific and correct type of footwear 303(75.75%), Avoid putting weight on ankle 302(75.5%), Pain relief medications 290(72.5%), calcium and vitamin D supplements 290(72.5%), warm foot bath 289(72.25%), cold applications 289 (72.25%), heat applications 202 (50.5%), stretching exercises for ankle 201(50.25%), elevation of ankle 124(31%) and acupressure and acupuncture 89(22.25%).

Most ankle pain gets better with rest, ice and over-the-counter pain medication. Once your pain subsides, gently exercise your ankle by rotating it in circles. Rotate in both directions and stop if it begins to hurt. These exercises will return your range of motion, help reduce swelling and speed up the recovery process. If pain is severe or ankle still hurts after a few days of at-home care, then a person must consult the health care provider at the earliest [9,10].

Ankle pain is often caused by common injuries like a sprain, or medical conditions like arthritis,  gout,  or  nerve damage. Discomfort commonly comes in the form of swelling and bruising for 1 to 2 weeks. During that time, for immediate at-home treatment of ankle pain, the Rest, Ice, Compression and Elevation of ankle (RICE) method for the first few days is recommended. OTC medication may provide some relief as well.

1. "Foot and Ankle Structure and Function." Physio-pedia, 14 June 2021, https://www.physio-pedia.com/Foot_and_Ankle_Structure_and_Function.

2. "Musculoskeletal Service: Foot and Ankle." Wuth, 14 June 2021, https://www.wuth.nhs.uk/our-departments/a-z-of-departments/musculoskeletal-service/foot-and-ankle/#:~:text=Most%20people%20experience%20pain%20in,%2C%20nerves%2C%20and%20blood%20vessels.

3. "Foot and Ankle Pain." Versus Arthritis, 15 June 2021, https://www.versusarthritis.org/about-arthritis/conditions/foot-and-ankle-pain.

4. "Ankle Pain." Cleveland Clinic, 16 June 2021, https://my.clevelandclinic.org/health/symptoms/15295-ankle-pain#:~:text=is%20ankle%20pain%3F-,Ankle %20pain%20refers%20to%20any%20kind%20of%20pain%20or%20discomfort,stiffness%20anywhere%20around%20the%20ankle.

5. "Ankle Pain." Healthline, 17 June 2021, https://www.healthline.com/health/ankle-pain.

6. "Ankle Pain Symptoms." Healthline, 18 June 2021, https://www.healthline.com/symptom/ankle-pain# TOC_TITLE_HDR_1.

7. "Foot Pain: Causes, Symptoms, and Treatments." Medical News Today, 19 June 2021, https://www.medicalnewstoday.com/articles/321469.

8. "R.I.C.E. Method for Injuries." WebMD, 20 June 2021, https://www.webmd.com/first-aid/rice-method-injuries.

9. "Ankle Pain When Walking." Healthline, 20 June 2021, https://www.healthline.com/health/ankle-pain-when-walking.

10. "Sprained Ankle Exercises." Medical News Today, 21 June 2021, https://www.medicalnewstoday. com/articles/sprained-ankle-exercises.