An ankle sprain can happen to anybody: athletes or non-athletes, children or adults, men or women. An ankle sprain involves ligaments that have been stretched beyond their normal position. The ligaments are structures that hold the bones of the ankle and joint in alignment, and they protect the ankle from abnormal twisting, rolling, or turning.
These elastic ankle components become sprained when there is actual tearing of the fibers. Recurrent sprains can result in long-term joint damage with pain and weakness. Proper treatment of an ankle sprain is necessary to prevent ongoing ankle problems.
What causes ankle sprains?
The ankle gets sprained when you make a fast, shifting movement with your foot planted on the ground. Many times, the ankle rolls outward while the foot turns inward, causing the ligaments on the outside to stretch and tear. The ligaments on the inside of the ankle can be injured when the ankle rolls inward as the foot goes outward. Any movement that causes the ligaments to stretch beyond their normal capacity causes an ankle sprain.
How is an ankle sprain diagnosed?
Ankle sprains are “graded” by our orthopedic specialists as mild (grade 1), moderate (grade 2), or severe (grade 3). With a grade 1 sprain, there is only slight stretching of the fibers with minimal damage to the ligament. With a grade 2 sprain, there is partial tearing of the ligament and laxity (looseness) of the ankle joint. An ankle sprain is a grade 3 when there is a complete tear of the ligament.
If you suspect you have an ankle sprain, see our doctors to be properly evaluated. He may order X-rays or an MRI. Also, doctors diagnose ankle sprains based on your injury history, the appearance of the ankle, and other physical examination techniques.
How is an ankle sprain treated?
If you have a sprained ankle, proper treatment and care is necessary for it to heal correctly. Most ankle sprains only need rest in order to heal while others require casting, a special splint or boot, or even surgery.
For a grade 1 ankle sprain, you should use R.I.C.E (rest, ice, compression and elevation):
- REST – Don’t walk on your ankle for a specified amount of time. Use crutches to get around.
- ICE – Apply ice wrapped in a soft cloth to the ankle. Do this for 20 minutes, four or five times a day to reduce swelling and ease pain.
- COMPRESSION – Use an ace-wrap type of dressing to immobilize the ankle and give it support.
- ELEVATE – Raise your ankle above the level of your heart. This is especially useful during the first 48 hours after the injury.
If your doctor tells you your sprain is a grade 2, the RICE method should be observed. Also, this level of injury takes more healing time. In addition, the orthopedic specialist may use a device to splint or immobilize your ankle while it heals. Grade 3 sprains are often associated with long-term instability.
While surgery is rarely necessary, a short leg cast or brace could be required for around three weeks. To prevent chronic ankle problems, the doctor may order physical therapy, ultrasound, or electrical stimulation.
A Grade 3 sprain can be associated with permanent instability. A short leg cast or a cast-brace may be used for two weeks to three weeks. If your ankle does not heal with conventional nonsurgical treatment and persistent instability exists, the orthopedic specialist may recommend surgery.
Reconstructive surgery involves repair of the torn ligament and grafting with other ligaments. Arthroscopic surgery is done when the doctor needs to look inside the joint for loose bone fragments or pieces of cartilage.
How does the ankle sprain resolve?
Ankle sprains recover in a stepwise method with three phases:
- Phase 1 – resting and protecting the ankle while reducing swelling (one week)
- Phase 2 – restoring range of motion, flexibility, and strength (one to two weeks)
- Phase 3 – gradually returning to normal activities (weeks to months)