Sprained Ankle

An ankle sprain occurs when one or more ligaments - fibrous bands of tissue that provide stability to the joint - are stretched or torn from excessive force, such as a sudden twisting during sports, stepping on an uneven surface, or a blow to the ankle.

A sprained ankle is a stretching or tearing of one or more ligaments, the tough fibrous bands that hold the ankle bones in place. Sprains can be caused by a sports injury, accident or stepping on an uneven surface. Symptoms may include pain, swelling, stiffness and bruising. There may be a popping sound when the ankle is moved. The ankle may be unstable or unable to hold weight.

Sprained ankles should be examined by a doctor to rule out the possibility of a bone fracture or other damage. Professional care will also ensure that the joint heals properly, limiting the chance of further injury.

Causes of Sprained Ankle

A sprained ankle is a very common injury that results in torn ligaments within the joint. Sprained ankles occur when the foot is twisted, rolled or turned in an abnormal motion. Although sprained ankles often happen during sports and other physical activities, they can occur in anyone at almost any time. Sprained ankles may even result from stepping the wrong way on an uneven surface or stepping down at an angle. Turning or moving the ankle in such a manner can result in a stretching or straining of the ligaments.

Symptoms of Sprained Ankle

The symptoms of a sprained ankle can vary, depending on the amount of stretching or tearing the ligament has sustained. The most common symptoms of a sprained ankle are pain, swelling, stiffness, bruising, tenderness and a decreased ability to bear weight on the ankle. Some patients may also hear a slight "popping" sound whenever they move their ankle. If the ligament has been completely torn or dislocated, the ankle joint can become very unstable.

Diagnosis of Sprained Ankle

The presence of swelling, tenderness and bruising are usually indicative of a sprained ankle. However, a physical examination will be conducted to help rule out other problems, such as a broken ankle. During the physical exam, the ankle will be moved in various ways to determine which ligaments have been torn or injured, and the severity of the sprain. Imaging tests such as X-rays may also be performed to confirm the diagnosis of a sprained ankle.

Types of Sprained Ankle

There are three categories of ankle sprains, based on the severity of the injury, and this grading system helps determine the best form of treatment.

  • Grade 1 sprain results from slight stretching and minor damage to the fibers of the ligament, leading to mild swelling and tenderness of the ankle
  • Grade 2 sprain results from a partial tear of the ligament, and is characterized by decreased motion, moderate swelling and minor ankle instability
  • Grade 3 sprain results from a complete tear of the ligament, leading to substantial instability and swelling of the ankle

Treatment of Sprained Ankle

Treatment of a sprained ankle will depend on the severity and type of sprain, although conservative methods are successful for the vast majority of these injuries. For Grade 1 sprains, RICE is generally recommended, which stands for rest, ice applications, compression such as a bandage for support and elevation of the ankle. For Grade 2 sprains, treatment will usually include a longer period of rest for the ankle joint, applications of ice to the area and use of a splint or another method of immobilizing the ankle. Grade 3 ankle sprains often require wearing a cast for two or three weeks. As the ligament heals, the patient can slowly begin resuming most normal daily activities.

For cases of sprained ankle in which extensive damage was sustained, surgery may be necessary. Surgery is generally only considered if courses of conservative treatments have failed to provide relief. Surgical options for a sprained ankle include arthroscopy, which involves the removal of loose bone fragments or damaged cartilage from the ankle joint, or reconstruction, during which the surgeon will repair a torn ligament with sutures or ligaments taken from another area of the ankle.

Recovery from Sprained Ankle

After receiving treatment for a sprained ankle, most patients will experience significant symptom relief and improved strength. Typically, full function of the ankle is restored. The length of time for complete recovery from a sprained ankle varies depending on the extent of the injury and the form of treatment that was used.

Prevention of Sprained Ankle

Sprained ankles can often be prevented by maintaining strength and muscle balance, especially prior to an athletic event. Patients may also be able to avoid a sprained ankle by stretching before exercising, wearing comfortable and well-fitting shoes and looking out for the presence of any uneven surfaces as they exercise or go about their daily activities.

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  • American Orthopaedic Society for Sports Medicine
  • American Association for Hand Surgery
  • American Academy Of Orthopaedic Surgeons
  • The American Board of Pediatrics