Sprained Ankle

A sprained ankle is a partial or complete tear of the ligaments that support the ankle. Ligaments are strong bands of tissue that cross joints and connect bones to each other. 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.

Causes

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 a person may have weak ankles. Previous ankle or foot injuries can also weaken the ankle and lead to sprains.

Symptoms

The symptoms of ankle sprains may include:

  • Pain, swelling, and bruising around the ankle
  • Worsening of pain when walking, standing, pressing on the sore area, or moving the ankle inward
  • Inability to move the ankle joint without pain
  • Possibly a popping or tearing sound at the time of the injury

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 there is no 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.

You should seek medical attention if you have:

  • Inability to move the ankle without significant pain
  • Inability to put any weight on that foot
  • Pain over a bony part of your foot or ankle
  • Pain that interferes significantly with walking
  • Pain not relieved by ice, pain relief medication, and elevation
  • Numbness in the leg, foot, or ankle
  • Pain that does not improve in 5-7 days
  • Uncertainty about the severity of the injury
  • Uncertainty about how to care for this injury

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition. In this case,

these include:

Playing sports;

Or having; poor coordination,  poor balance, inadequate strength in muscles and loose ligaments and or loose joints.

The Podiatrist will:

Ask about your symptoms and how the injury occurred and examine your ankle to assess the severity of the injury.

Tests may include:

  • Palpation - to assess location and tenderness
  • X-rays - to make sure that no bones are broken
  • MRI scan - to see if a ligament has torn completely (rarely needed)

Ankle sprains are graded according to the damage to the ligaments. The more ligaments involved or severity of single ligament damage, the more severe the injury.

Grade 1

  • Some minor microscopic tearing of ligament tissue fibres, but the ankle remains stable. Clinically presents with mild swelling, usually pin-point tenderness overlying the injured ligament, restricted ankle joint range of motion and the possibility to fully bear weight.

Grade 2

  • Damage to two ankle ligaments, partial tearing of one ligament and possible complete tear of another.  Moderate swelling and tenderness typically along the front and side of ankle joint and mild to moderate instability of the ankle joint with restricted joint range of motion.

Grade 3

  • Significant severe and complete tearing or rupture of two ligaments, presents clinically with marked swelling with tenderness overlying damaged ligaments with complete laxity and significant instability of the ankle joint.

Non-surgical Treatment

When you have an ankle sprain, rehabilitation is crucial—and it starts the moment your treatment begins. Your Podiatrist may recommend one or more of the following treatment options;

  • Rest. Stay off the injured ankle. Walking may cause further injury.
  • Ice. Apply an ice pack to the injured area, placing a thin towel between the ice and the skin. Do not apply the ice directly to your skin. Use ice for 20 minutes and then wait at least 40 minutes before icing again four times a day for at least 2-3 days.
  • Compression. An elastic wrap may be recommended to control swelling.
  • Elevation. The ankle should be raised slightly above the level of your heart to reduce swelling.
  • Early physical therapy. Your Podiatrist  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.
  • Rehabilitation exercisesBegin exercises to restore flexibility, balance, proprioception, range of motion, and strength of the muscles around your ankle as recommended by your podiatrist.
  • Orthotics, Ankle brace or taping — You may need orthotics to provide stability and alignment within your feet, you may also need to wear a brace to immobilise your ankle. In many instances, a brace, which stabilises and compresses the ankle, may allow for early weight bearing and an earlier return to activity. If you play sports, you may need to wear an ankle brace or tape your ankle when you return to play.

Return to previous activity level or sport is appropriate after functional exercises can be performed without pain during or after activity.


WARNING : This information is for educational purposes only and is not intended to replace professional podiatric advice. Treatment will vary between individuals depending upon your diagnosis and presenting complaint. An accurate diagnosis can only be made following a personal consultation with a Podiatrist.