ANKLE SPRAINS

Ankle sprains are one of the most common injuries to the foot and ankle.  It is caused by turning or twisting your ankle and overstretching or even tearing the ligaments of your ankle. Ankle sprains can range from mild to severe and recurrent ankle sprains, or untreated ankle sprains can lead to chronic ankle instability.

Most sprained ankles occur in the lateral ligaments on the outside of the ankle. Sprains can range from tiny tears in the fibers that make up the ligament to complete tears through the tissue.

Grade 1 Sprain (Mild)

• Slight stretching and microscopic tearing of the ligament fibers
• Mild tenderness and swelling around the ankle

Grade 2 Sprain (Moderate)

• Partial tearing of the ligament
• Moderate tenderness and swelling around the ankle
• If the doctor moves the ankle in certain ways, there is an abnormal looseness of the ankle joint

Grade 3 Sprain (Severe)

• Complete tear of the ligament
• Significant tenderness and swelling around the ankle
• If the doctor pulls or pushes on the ankle joint in certain movements, substantial instability occurs

If there is a complete tear of the ligaments, the ankle may become unstable after the initial injury phase passes. Over time, this instability can result in damage to the bones and cartilage of the ankle joint.

Ankle sprains can be treated conservatively most of the time, treatment often consists of anti-inflammatory medications, immobilization, and therapy. If untreated ankle sprains can become recurrent and there is a risk the ligament will not heal properly.

Symptoms

Ankle sprains are painful injuries that can cause bruising, swelling, and pain to the affected ankle. They can result from walking on unever surfaces, rolling an ankle, sports that require “cutting” movements, and trips and falls.

Diagnosis

Your physician will perform a physical exam to determine the extent of the sprain and the stability of the ankle.

X Rays will likely be performed to rule out a fracture, it is not uncommon with these injuries to believe it is only a sprain when there is a fracture present to the ankle.

MRI can be utilized to give more specific information about the severity and extent of the sprain.

Treatment

Immobilization in a brace, boot, or cast is often required for 3-4 weeks for treatment of a sprain depending on its severity.

Physical therapy is an important tool to not only treat a sprain, but to help prevent future injuries as well.

• Early motion.To prevent stiffness, your doctor or physical therapist will provide you with exercises that involve range-of-motion or controlled movements of your ankle.
• Strengthening exercises.Once you can bear weight without increased pain or swelling, exercises to strengthen the muscles and tendons in the front and back of your leg and foot will be added to your treatment plan..
• Proprioception (balance) training.Poor balance often leads to repeat sprains and ankle instability. Proprioceptive and balance training can help prevent future sprains and “train” you to prevent motions that cause injuries.

Patients often do well with conservative treatment and the outcomes for ankle sprains when treated are very good. Patients rarely require surgery for acute sprains, however untreated sprains or recurrent sprains that lead to instability may require surgical intervention for stabilization.