Ankle Sprain

The ankle is composed of various bones forming a joint. Ligaments are the elastic structures that are responsible for holding these bones in their proper place. Ligaments and other soft tissues function to prevent abnormal movement, such as twisting, turning, and rolling of the foot beyond the normal range.

Ankle sprains are a common and painful condition in which ligaments supporting the ankle joint are torn or damaged. Sprains are most often treated conservatively by resting the injured joint, applying ice to the injury, using a compression bandage, and elevating the foot. An ankle brace and physical therapy will be prescribed after the initial swelling and pain subside.

Causes

Ankle sprains usually occur due to sudden inward or inverted movement of the foot during sports activities, or while walking or running on uneven surfaces. Less commonly, the foot everts or moves outward, damaging the medial ankle. Ankle sprains usually occur from falling or sudden force or impact that twists the joint beyond its normal range, resulting in damage to the ligament. Ankle sprains may occur at any age and, although commonly associated with sports injuries, may occur with simple activities of daily living.

Symptoms

Ankle sprains generally result in pain, swelling, bruising, and/or stiffness of the ankle region. Mobility, range of motion, and weight-bearing are adversely affected. The severity of the ankle sprain depends on the condition of the torn ligament.

Grades of Ankle Sprain

Based on the severity of the ligament’s condition, ankle sprains are categorized as grade 1,2, or 3.

Grade 1: a mild sprain with minimal damage to the ligament fibers.

Grade 2: a moderate sprain with partial tearing of the ligament.

Grade 3: a severe sprain with complete tearing of the ligament.

Diagnosis

Diagnosis of an ankle sprain starts with a physical examination. X-rays are usually taken to confirm whether a fracture is present, as the symptoms of a sprain are similar.

Treatment

Treatment and healing will depend on the grade of the sprain. All sprains are initially treated using the R.I.C.E. method: Rest, Ice, Compression, and Elevation.

Your provider may also order the following additional treatment:

Immobilization: A boot may be used to immobilize the ankle, to increase healing as well as decrease pain.

Medications: Medications such as aspirin and NSAIDs (non-steroidal anti-inflammatory drugs) can be prescribed for comfort and to minimize swelling.

Physical Therapy: Strengthening and range of motion exercises may be prescribed to regain normal function of the ankle and prevent chronic ankle problems. Your physical therapist may utilize ultrasound and electrical stimulation to decrease pain and swelling and may give instructions on taping to support the ankle while it heals.

Surgery to repair ankle sprains is rarely needed, but may be necessary if the sprain is a grade 3 sprain involving complete tearing of the ligament, and if the patient does not improve with conservative treatment.