An ankle sprain occurs when the foot twists or turns beyond its natural range of motion, causing ligaments in the ankle to stretch or tear. Ankle sprains are the most common foot and ankle injury. According to the American Academy of Orthopaedic Surgeons, approximately 25,000 people experience ankle sprains every day. A sprained ankle can occur in children and adults of any age.
What Causes an Ankle Sprain?
A sprained ankle happens when there is sudden twisting or sideways movement of the foot, typically during sports. However, it can also happen when walking on uneven surfaces or when taking an awkward step during everyday activities. Some patients suffer from chronic ankle sprains, which means that they have recurring ankle sprain injuries due to the loosened ligaments in the ankle joint.
What Does it Feel Like? What are the Symptoms?
The primary symptoms of a sprained ankle are pain and swelling. The pain can increase when standing, walking or moving the ankle. The ankle may also feel warm due to the inflammation. Patients with a severe ankle sprain may experience difficulty walking on the injured ankle and significant swelling.
Types of Ankle Sprains
Severity of an ankle sprain varies from the ligament being simply stretched, slightly torn, or completely ruptured. As with any injury, consult your doctor for an appropriate diagnosis. In more severe sprains, you are often unable to walk or even put weight on your foot, and your ankle may feel unstable. You usually have a lot of pain at first, but it can significantly decrease after the first hour. If your ankle sprain does not get treated and heal properly you may be more susceptible to re-injury.
Your physician may use the following grading system to determine your injury level:
Injury involves only a mild stretch of the ligament. Patients are usually able to bear weight on the ankle immediately following injury.
Injury involves some ligament tearing and patient generally experience more significant pain and swelling. They can usually bear some weight.
Injury involves a complete tear of one or more ligaments. Significant pain, swelling, and bruising are usually present. The patient will demonstrate clinical, as well as functional instability. Weight bearing for this person is usually difficult.
Ankle sprains may also be classified based on its location on the ankle.
Inversion Ankle Sprain
An ankle sprain occurs when the ligaments that connect the bones in the foot, ankle, or lower leg, are stretched or torn. Inversion ankle sprains happen most frequently. During an inversion ankle sprain the anterior talofibular ligament (ATFL) is most commonly injured followed by the calcaneofibular ligament.
Eversion Ankle Sprain
Eversion ankle sprains occur less often and are usually more severe. Damage to the deltoid ligament occurs with this type of sprain, however due to the deltoid's strength it can often result in an avulsion fracture of the medial malleolus rather than damage to the ligament.
High Ankle Sprain
A high ankle sprain injures the large ligament above the ankle that joins together the two bones of the lower leg. These two bones, the tibia (shin bone) and fibula, run from the knee down to the ankle. They are joined together by this ligament, called the "syndesmosis" or sydesmotic ligament.
Patients who sustain a high ankle sprain injure this syndesmotic ligament. The ligament can also be associated with more common low ankle sprains, and even ankle fractures.
How Do I Treat an Ankle Sprain?
After a medical professional has determined the severity of the ankle injury, initial treatment can follow the RICE principle for healing an ankle sprain.
Crutches and/or some type of ankle support should be used until walking is not painful.
After the compression bandage has been applied, use ice packs or an ice wrap to decrease the temperature of the injured area. Ice should be applied for 20 minutes every 1 to 2 hours for the first 24 to 72 hours, or until swelling goes down. Do not expose the area to prolonged cold. The Aircast Ankle Cryo/Cuff with Cooler is great for cold therapy and compression to help you recover from ankle sprains faster.
An elastic pressure bandage or wrap can be applied around the ankle at the site of the sprain. This will help decrease swelling and should be worn for the first 24 to 36 hours. Compression wraps do not offer protection, and a protective brace should be used if you try to bear weight on your injured ankle. Don't apply the wrap too tightly. Loosen the bandage if it gets too tight. Signs that the bandage is too tight include numbness, tingling, increased pain, coolness, or swelling in the area below the bandage.
Promptly elevate the injured limb. If possible, it should be raised above the level of the heart for at least 2-3 hours a day for the first 24 to 36 hours to help reduce swelling and bruising. The easiest way to achieve this is to lie on your back and prop the injured limb up on some pillows.
The best way to heal an ankle sprain is through functional management. This means that the patient continues to use the ankle while recovering from injury. Ankle movement helps prevent stiffness in the ankle as the ligaments recover. The leading ankle brace for the functional management of ankle sprains is the Aircast Air-Stirrup. It allows natural movement while still supporting the ankle, unlike a walking boot which would limit mobility while healing.
Additionally, some physicians may also prescribe strengthening and range of motion exercises to stimulate rehabilitation of the ankle. Wearing a brace for ankle sprains can help prevent re-injury, especially during sports and other physical activity. Getting back into sports is possible after an ankle sprain, work on restoring strength, mobility and balance.