Campaign Pushes At-Home Exercises

                     by LAURAN NEERGAARD
                     AP Medical Writer

                     WASHINGTON (AP) -- Call a sprained ankle the injury that gets little respect.
                     Some ice, elevate the foot, and it'll be fine, right? Actually, millions of sufferers
                     have weak ankles at risk of repeated sprains, chronic pain or other injury because
                     they improperly treated that first sprain.

                     Now specialists are starting a campaign to help Americans properly treat a
                     sprained ankle with at-home strengthening exercises that can work as well as
                     formal physical therapy -- and to help particularly vulnerable teen-age athletes
                     prevent this common injury in the first place.

                     Orthopedists estimate an astounding 27,000 Americans a day sprain an ankle. It's
                     the top orthopedic complaint and most common sports injury, among regular
                     athletes and weekend warriors alike.

                     ''People try to play through it, work through it,'' laments Dr. Glenn Pfeffer of the
                     University of California, San Francisco, who sees half a dozen patients daily who
                     improperly treated a sprain and thus months later remain in pain.

                     Why? Because ''no one's ever said to us, 'If you don't take care of your ankle
                     sprain, you can run into trouble.'''

                     A sprain is a stretching or tearing of the elastic ligaments that connect bones in
                     the ankle, caused when your ankle sharply turns inward or outward.

                     Studies show up to 40 percent of sprained ankles lead to recurring sprains,
                     unstable joints, arthritis-like pain or other complications. And the earlier in life
                     that first sprain, the higher the risk for repeat problems.

                     So the American Orthopedic Foot and Ankle Society this month is mailing all
                     high schools a video explaining how young athletes can prevent sprains by
                     wearing ankle braces -- and joint specialists are advocating at-home exercises to
                     help many sprain sufferers prevent future injury.

                     For initial sprain treatment, think RICE: rest, ice, compression with an elastic
                     ankle wrap, and elevation.

                     But significant sprains need more -- a brace to protect the recovering joint,
                     range-of-motion exercises to prevent stiffness, and muscle strengthening and
                     balance-restoration exercises to prevent future injuries, says Dr. Michael
                     Bowman, a Pittsburgh orthopedist who also helps treat the Pittsburgh Steelers.

                     Can you do that at home? Bowman studied 64 patients with moderate to severe
                     sprains. Everyone got a brace. Half got physical therapy three times a week; the
                     rest got an at-home kit Bowman designed with day-by-day exercise instructions.
                     It also included such equipment as elastic bands, sold in sporting-good stores, to
                     put around chair legs and stretch the ankle inward or outward, and rocking
                     boards to stretch and flex.

                     Both groups recovered equally well, Bowman will tell a meeting of the American
                     Academy of Orthopedic Surgeons this week. But at-home treatment cost about
                     $120, versus $650 for physical therapy.

                     Pfeffer stresses that anyone with a severe sprain or continuing pain should see a
                     specialist. But he says many sprain sufferers can buy a drugstore brace for $25
                     to $50 and then -- once swelling diminishes enough to walk normally -- try three
                     even simpler versions of Bowman's exercises without buying special equipment:

                     --Put the front of your foot through the handles of a plastic grocery bag
                     containing a can or two of soup and lift your toes toward the ceiling. Hold it for
                     3 seconds; repeat 10 times twice a day.

                     --Stand on a stair and stretch the heel downward over the edge, keeping the knee
                     straight, until you feel a pull in the calf and bottom of the foot. Stretch for 30
                     seconds, four to six times a day.

                     --For balance, stand on just the injured leg with your eyes closed, building up to
                     30 seconds and repeating three times twice a day.

                     But preventing that first sprain is best -- and Dr. Carol Frey of Los Angeles'
                     West Coast Sports Performance says wearing a brace during sports, especially
                     sprain-prone ones like volleyball or tennis, can help.

                     Many athletes tape their ankles, but tape begins loosening after just 10 minutes of
                     exercise. So Frey studied bracing among 402 Southern California high school
                     volleyball players. Seven of the 140 male players suffered a sprain in a season,
                     none of whom wore the brace. Fifteen of the 262 female players sprained ankles,
                     only five while wearing the brace.

                     Frey's study is continuing to follow more than 3,000 additional players to see if
                     other factors like weight or preseason conditioning play a role, and if girls' ankles
                     truly are more vulnerable.