Ankle Sprain

A sprained ankle occurs when the foot turns sharply and over stretches the ligaments, tendons, and muscles that connect the bones of the foot to the ankle. Ankle sprains are extremely common in athletics due to the relative instability of the ankle joint and the very high amount of weight they bear.

The base of the two lower leg bones (the tibia and fibula) meet the large bone of the ankle joint (the talus) and are connected by ligaments, which are tight connective tissue strips that connect bone to bone. If one of these ligaments is overstretched, torn, or ruptured, the ankle is "sprained". A "strain" is an over stretching of muscles or tendons rather than a stretching of the ligaments.

Types of ankle sprains
The most common and mildest sprains are called "First Degree" sprains. In this case, the ligaments are stretched, but not torn. Pain and swelling are usually mild and some amount of weight bearing can be done on the ankle. "Second Degree" sprains are moderate and usually include a partial tear of ligaments. Pain and swelling are increased. "Third Degree" sprains are the most severe sprains and include severe pain, skin discoloration from bleeding beneath the skin. In extreme cases the ankle may dislocate. This severe injury can involve surgery. People with third degree ankle sprains can not put weight on the affected ankle. These more sprains usually require a long rehabilitation period.

How does it occur?
Any traumatic twisting of the foot, most commonly inward, can stretch or tear the ligaments on the outside of the ankle. Ankle sprains can occur during running, athletic sports such a soccer and football, or even stepping into an area of uneven pavement on a sidewalk or road.

What are the signs and symptoms?
The symptoms of an ankle sprain depend on the severity of the injury, but most injuries include:

  • Moderate to severe pain
  • Decreased ability to stand or walk on the injured ankle
  • Bruising
  • Swelling
  • Instability

How are ankle sprains diagnosed?
Your doctor can diagnose an ankle sprain by examining the ankle and by taking X-rays to rule out fractures or dislocations at the ankle. Severe ankle sprains can be seen on CT (computerized tomography) and MRI (magnetic resonance imaging) films, which look at soft tissues such as muscles, tendons, and ligaments.

How are ankle sprains treated?
The best treatment for mild and moderate ankle sprains is R.I.C.E.:

  • Rest - Staying off the injured ankle and limiting activities will allow the tissues to heal most quickly. Your doctor may recommend that you wear a splint or short leg cast as well to hold the joint still.
  • Ice - Using ice packs 3 - 4 times daily for about 20 minutes at a time help reduce swelling and pain.
  • Compression - Wrapping the ankle in a compression bandage or taping the ankle reduces swelling and restricts mobility, which will greatly speed recovery time.
  • Elevation - Raising the ankle while seated and reclining help to reduce swelling and pressure at the joint. Rolled soft towels or pillows under the knee work well to help lift the knee above the hip while reclining on a bed.

Your doctor may also recommend that you take non-steroidal anti-inflammatory drugs to help with pain during your recovery. Ankle sprains, if cared for properly, heal within three to six weeks.

In the most severe cases, your doctor may recommend crutches or several weeks in a cast to help immobilize the ankle and to speed recovery. Surgery for ankle sprains is quite rare.

How are ankle sprains prevented?

    Stretch out ankles and legs fully
    Warm up before and after heavy exercise
    Wear shoes that fit properly and are well cushioned
    Take care when walking on uneven surfaces
    Maintain a healthy weight and active lifestyle