DAVID FOLK THOMAS: I would imagine it would be hard, unless you've had injuries recurring over time, it would be hard to diagnose yourself. How would the average person know unless they had had a lot of ankle sprains, whether they had sprained their ankle or perhaps broken their ankle?
JONATHAN GLASHOW, MD: That's a good question. I think a general rule is when in doubt, seek treatment. I think there is a timeframe element. If it lasts more than 24 hours, if it's progressive or getting worse, those are cardinal signs that you may need attention. If it's something that happens again, their knee buckles and then it buckles again, I think that's another cardinal sign. If there is bleeding, of course, people should go. If there is neurologic or nerve damage in which people feel numbness, tingling or weakness, those are key signs that should alert them to seek professional medical help. But in the absence of overt swelling or increase in size, which would be a sign to go the emergency room, and if they can put weight or walk on that leg, then I think they have the luxury of waiting a little bit. Icing it and doing what we talked about, general anti-inflammatory, which one can buy over-the-counter, if it gets better, hold off. But if the trend is a progressive one toward the worsening, then I think they need to seek attention. I guess if they hadn't had problems in that area in the past, it may be safer to wait, where if it's a recurrent injury maybe seeking earlier treatment is a good idea.
