An ankle sprain occurs when the ligaments that support the ankle joint are stretched beyond their normal range of motion and tear. Ankle sprains can range from mild to severe, and are common injuries for people of all ages. Most ankle sprains are minor injuries that heal on their own with rest, ice, and therapy. Ankle sprains are graded based on how much damage has occurred to the ligaments of the ankle joint.
Grade 1 Sprain (Mild)
- Slight stretching accompanied by microscopic tearing to the ligament fiber
- Mild tenderness and swelling
Grade 2 Sprain (Moderate)
- Partial tearing of the ligament
- Moderate tenderness and swelling
- Abnormal looseness of the ankle joint
Grade 3 Sprain (Severe)
- Complete tear of the ligament
- Significant tenderness and swelling
- Substantial instability on the ankle joint
Common causes of sprained ankles include:
- A rolling or twisting of the ankle beyond their normal limit
- A fall that causes the ankle to twist
- Landing awkwardly after a jump or pivot
- Walking or exercising on an uneven surface
- Another person stepping or landing on your foot during sports activity
There are also a number of factors that can increase the likelihood of a sprained ankle, including:
- Sports Activities: ankle sprains are a common sports injury. Most sports involve quick bursts, sudden stops, jumping, cutting, and sudden change in direction. These athletic movements put you at a higher risk for ankle injuries.
- Uneven surfaces: walking or running on uneven surfaces can also increases your risk of injury.
- Poor physical condition: poor strength and flexibility in the ankle puts added stress on the ankle joint.
- Prior ankle injuries: once you have sprained your ankle and damaged the ligaments in the ankle joint, you are more like to sprain that ankle again in the future.
- Improper shoes: ill-fitting shoes and shoes that are not sport specific make ankles more vulnerable to injury.
SIGNS AND SYMPTOMS
- Pain when bearing weight on the affected foot
- Swelling and bruising
- Tenderness to the touch
- Restricted range of motion
- Instability of the ankle joint
- Popping sound heard at the time of injury
Treatment options for an ankle sprain depend on the severity of the sprain. The primary goals when treating an ankle injury are to reduce pain and swelling, allow the strained ligament to heal, and regain normal function of the ankle joint. More severe ankle injuries may require physical therapy and even surgery.Conservative TreatmentFor non-surgical treatment of low grade ankle injuries, use the R.I.C.E method for the first few days following the injury:
- Rest: avoid activities that cause pain, swelling, or discomfort.
- Ice: ice the ankle joint for 15 to 20 minutes every two to three hours to reduce inflammation.
- Compression: use an elastic bandage to compress the ankle until the swelling has stopped. Be careful not to hinder circulation by wrapping the bandage too tight. When wrapping the ankle, always start at the end farthest from your heart.
- Elevation: elevate your ankle about the level of your heart to reduce swelling. Gravity will help drain any excess fluid.
Over-the-counter medications, such as ibuprofen (Advil, Motrin IB), Aleve, and Tylenol can help manage pain related to a sprained ankle. Depending on the severity of the ankle sprain, your physician may recommend an ankle brace to help stabilize the joint. If walking is painful, you may need to use crutches until the pain has subsided. Physical therapy can also help restore your ankle’s range of motion, strength, flexibility, and stability.
Surgery may be required to correct recurring ankle sprains, or chronic ankle instability. The goal of surgery is to tighten and stabilize the loose or torn ligaments of the ankle. The recovery process typically includes two week without putting any weight on the surgically repaired ankle. During this time crutches or a rolling knee scooter will be necessary. After two weeks, patients will being bearing weight on the ankle. A protective boot is used for approximately four weeks while the ankle continues to heal. Physical therapy is an important part of recovery, so patients will be expected to complete a therapy program. Most patients can return to some athletic activities 10 weeks after surgery. A full recovery can take from six month to a year.