What is an Ankle Sprain? An ankle sprain is an injury to one or more ligaments in the ankle, most often on the outside of the ankle. Ligaments are bands of tissue that connect one bone to another. They keep the joints connected together. In the ankle joint, ligaments provide stability by limiting side-to-side movement.
Some ankle sprains are much worse than others. The severity of an ankle sprain depends on whether the ligament is stretched, partially torn, or completely torn, as well as on the number of ligaments involved. Ankle sprains are not the same as strains, which affect muscles rather than ligaments.
What Causes a Sprained Ankle?
Sprained ankles often result from a fall, a sudden twist, or a blow that forces the ankle joint out of its normal position. Ankle sprains commonly occur while participating in sports, wearing inappropriate shoes, or walking or running on an uneven surface.
Sometimes ankle sprains occur because of weak ankles, a condition that some people are born with. Previous ankle or foot injuries can also weaken the ankle and lead to sprains.
Sprains are divided into several groups depending on the severity of damage to the involved ligament.
How Do We Grade Our Ankle Sprains?
A Grade I (First Degree) sprain is the most common and requires the least amount of treatment and recovery. The ligaments connecting the ankle bones are often over-stretched, and damaged microscopically, but not actually torn. The ligament damage has occurred without any significant instability developing.
Grade I Sprain
A Grade II (Second Degree) injury is more severe and indicates that the ligament has been more significantly damaged, but there is no significant instability. The ligaments are often partially torn.
Grade II Sprain
A Grade III (Third Degree) sprain is the most severe. This indicates that the ligament has been significantly damaged, and that instability has resulted. A grade III injury means that the ligament has been torn.
Grade III Sprain
Signs and Symptoms The signs and symptoms of ankle sprains may include:
- Pain or soreness
- Difficulty walking
- Stiffness in the joint
These symptoms may vary in intensity, depending on the severity of the sprain. Sometimes pain and swelling are absent in people with previous ankle sprains-instead, they may simply feel the ankle is wobbly and unsteady when they walk. Even if you don't have pain or swelling with a sprained ankle, treatment is crucial. Any ankle sprain-whether it's your first or your fifth-requires prompt medical attention.
If you think you've sprained your ankle, contact us or a foot and ankle surgeon for an appointment as soon as possible. In the meantime, immediately begin using the "R.I.C.E." method-Rest, Ice, Compression, and Elevation-to help reduce swelling, pain, and further injury.
Why Prompt Medical Attention is Needed
There are four key reasons why an ankle sprain should be promptly evaluated and treated by a foot and ankle surgeon:
1. An untreated ankle sprain may lead to chronic ankle instability, a condition marked by persistent discomfort and a "giving way" of the ankle. You may also develop weakness in the leg.
2. You may have suffered a more severe ankle injury along with the sprain. This might include a serious bone fracture that could lead to troubling complications if it goes untreated.
3. An ankle sprain may be accompanied by a foot injury that causes discomfort but has gone unnoticed thus far.
4. Rehabilitation of a sprained ankle needs to begin right away. If rehabilitation is delayed, the injury may be less likely to heal properly.
In evaluating your injury, the foot and ankle surgeon will take your history to learn more about the injury. He or she will examine the injured area, and may order x-rays, an MRI study, or a CT scan to help determine the severity of the injury.
Non-Surgical Treatment and Rehabilitation
- Immobilization. Depending on the severity of your injury, you may receive a short-leg cast, a walking boot, or a brace to keep your ankle from moving. You may also need crutches.
- Early Physical Therapy. Your doctor will start you on a rehabilitation program as soon as possible to promote healing and increase your range of motion. This includes doing prescribed exercises.
- Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be recommended to reduce pain and inflammation. In some cases, prescription pain medications are needed to provide adequate relief.
- Icing. You may be advised to ice your injury several times a day until the pain and swelling resolves. Wrap ice cubes, or a bag of frozen peas or corn, in a thin towel. Do not put ice directly on your skin.
- Compression Wraps. To prevent further swelling, you may need to keep your ankle wrapped in an elastic bandage or stocking.
When you have an ankle sprain, rehabilitation is crucial-and it starts the moment your treatment begins. Your foot and ankle surgeon may recommend one or more of the following treatment options:
When is Surgery Needed?
In more severe cases, surgery may be required to adequately treat an ankle sprain. Surgery often involves repairing the damaged ligament or ligaments. The foot and ankle surgeon will select the surgical procedure best suited for your case based on the type and severity of your injury as well as your activity level.
After surgery, rehabilitation is extremely important. Completing your rehabilitation program is crucial to a successful outcome. Be sure to continue to see your foot and ankle surgeon during this period to ensure that your ankle heals properly and function is restored.