Ankle Sprain: Overview
A sprain involves damage to a ligament. In a mild injury, the ligament
may only be stretched, resulting in microscopic injury to the ligament.
In a more severe sprain, the ligament may actually tear or rupture.
The ankle is a hinge joint formed by the junction of the tibia and fibula,
two long leg bones, with the talus. The lateral (outside) complex of the
ankle also comprises three major ligaments:
The medial (inside) complex of the ankle includes the large deltoid ligament. The weaker lateral ligaments are involved in the majority of ankle sprains.
Ankle sprains may be caused by:
Risk factors that increase your chances of spraining your ankle include:
Diagnosis
An ankle sprain may not require a visit to the doctor. However, you should
call your doctor if:
The doctor will ask about your symptoms and how the injury occurred. He will also examine your ankle to assess the stability of the joint and the severity of the injury. Tests may include:
Ankle sprains are graded according to the damage to the ligaments. In addition, the more ligaments involved the more severe the injury.
Grade1
Grade 2
Grade 3
Injuries can occur either in the ligament's midsubstance or at the point of attachment to the bone. Of the three lateral complex ligaments, the most frequently injured is the ATF, the weakest of the ankle ligaments.
The injury can occur in isolation or can be combined with injury to other ankle ligaments. The mechanism of injury is usually a sudden twist (the foot most often inverts or turns inward). Performing movements that require agility puts an athlete at risk for ankle sprains.
Symptoms of an ankle sprain include:
Treatment Options
Treatment includes:Avoid putting any pressure on your ankle by not walking on it.
Apply ice or a cold pack to the ankle for 15-20 minutes, 4 times a day for at least 2 to 3 days. This helps reduce pain and swelling. Wrap the ice or cold pack in a towel. Do not apply the ice directly to your skin.
Wrap your ankle in an elastic compression bandage (e.g., Ace bandage). This will limit swelling of your ankle.
Keep your ankle raised above the level of your heart for 48 hours. This will help drain fluid and reduce swelling.
Take one of the following drugs to help reduce inflammation and pain:
- ibuprofen (Motrin, Advil)
- naproxen (Aleve, Naprosyn)
- acetaminophen (Tylenol)
- aspirin
You may need to wear a brace to immobilize your ankle. If you play sports, you may need to wear an ankle brace or tape your ankle when you return to play.
If you have a severe sprain, your doctor may recommend a short leg cast for two to three weeks, but this is very rare.
Begin exercises to restore flexibility, range of motion, and strength of the muscles around your ankle as recommended by your health care professional.
Surgery is rarely needed to repair an ankle sprain. However, it may be needed to repair a ligament that is torn completely.
Prevention
Many ankle sprains cannot be prevented. To reduce your risk of spraining an ankle:
How Athletes Can Prevent Ankle Sprains
Many ankle sprains cannot be prevented. To reduce your risk of spraining an ankle:
Improving Sports Performance
The key to improving sports performance after an ankle sprain is a proper rehabilitation program, and adhering to some of those same principles after the injury is gone.
The most important aspects of improving performance after a sprain are:
Rehabilitation for ankle sprains
Ankle sprains are one of the most common sports injuries. As an athlete, you may already know that one of the most common and best ways to begin rehabilitating a sprain is RICE:
Avoid putting any pressure on your ankle by not walking on it.
Apply ice or a cold pack to the ankle for 15-20 minutes, 4 times a day for at least 2 to 3 days. This helps reduce pain and swelling. Wrap the ice or cold pack in a towel. Do not apply the ice directly to your skin.
Wrap your ankle in an elastic compression bandage (e.g., Ace bandage). This will limit swelling of your ankle.
Keep your ankle raised above the level of your heart for 48 hours. This will help drain fluid and reduce swelling.
You can begin exercise rehabilitation when the swelling subsides, which is usually a few days after the injury. Because warmed tissue is more flexible and less prone to injury, you may want to warm the ankle before doing rehabilitation exercises. Use ice when finished to minimize any irritation to the tissue caused by the exercise.
To get you back in the game as quickly as possible, there are three main goals in rehabilitating the ankle:
Gently move the ankle up and down. After 5 to 7 days, try restoring motion to the hind foot by turning the heel in and out. To restore flexibility in your calf muscle, try facing a wall with one foot in front of the other and lean forward with your hands on the wall. Bend the front leg while keeping the back leg straight and both heels on the floor. Lean forward until you feel a gentle stretch, and hold for ten seconds. Switch legs and repeat.
Once motion is restored, you can begin strengthening exercises using a rubber tube for resistance. Fix one end of the tube to an immovable object like a table leg, and loop the other end around the forefoot. Sit with your knees bent and heels on the floor. Pull your foot inward against the tubing, moving your knee as little as possible. Return slowly to the starting position. Repeat with the other foot.
You can also sit on the floor with your knees bent and the tube looped
around both feet. Slowly pull outward against the tube, moving your knee
as little as possible. Return slowly to the starting position. Repeat
with the other foot.
As your ankle gets stronger, the next task is restoring balance. Try standing on the injured leg, with your hands out to your sides, and hold position for 30 seconds. Repeat this exercise until balance is achieved.
When can I return to my sport or activity?
How long will the effects of the injury last?
With proper rehabilitation, an ankle sprain usually lasts two weeks. If the injury has recurred several times, full recovery may take as long as six weeks.
