Sprained ankle

Sprained ankle

A sprained ankle is a very common injury. According to the American Academy of Orthopaedic Surgeons (AAOS), approximately 25,000 people a day experience a sprained ankle. A sprained ankle happens when an ankle ligament is forced to stretch past its normal range of motion. Ankle ligaments are tough, fibrous bands of tissue that hold your ankle bones and joint in position. Their job is to protect your ankle from abnormal movements such as twisting, turning and rolling your foot. The very nature of a ligament is its flexibility to stretch within certain limits and then return to its normal position, thus allowing a safe range of motion for your joints. Most ankle sprains need about four to six weeks to heal.

Symptoms

You may experience one or all of these symptoms of an ankle sprain:

  • Pain, particularly when you put weight on your injured foot
  • Ankle swelling and sometimes bruising
  • Restricted range of motion
  • Abnormal "looseness" of your ankle
  • Instability of your ankle
  • Hearing or feeling a "pop" at the time of injury

Causes

A severe sprained ankle can mean that the elastic fibers of one or more ligaments of your ankle were stretched or torn. You can sprain your ankle when you're playing sports or performing physical fitness activities, or a sprained ankle can happen when you simply step on an uneven surface or step down at an angle.

Types

  • Inversion ankle sprains – The sprain occurs when the foot is inverted, falling inward, which damages the ligaments and causes pain on the outer side of the ankle. Approximately 90 percent of sprained ankles are inversions.
  • Eversion ankle sprains – The sprain occurs when the foot is twisted outwards, which stretched the inner ligament (deltoid) too far. It causes pain on the inner side of the ankle.

Sprained ankles are graded on how mild or severe the strain is:

  • Grade 1 – A mild strain causes slight stretching and some damage to the fibers of the ligament. You'll experience some pain and swelling, but you should be able to walk without crutches.
  • Grade 2 – This more severe sprain causes partial tearing of the ligament. When your ankle joint is examined and moved in certain ways, abnormal looseness (laxity) of the ankle joint occurs with a grade 2 sprain. You'll experience more significant swelling and bruising and more pain with walking.
  • Grade 3 – The most severe ankle sprain, this causes a complete tear of a ligament. When your physician pulls or pushes on your ankle joint in certain movements, gross instability of your ankle occurs. You'll experience more severe pain and will feel as if your ankle joint in unstable.

Treatment

Depending on the severity, treatment options for your sprained ankle may include one or more non-surgical treatment options or, in rare cases, surgery.

  • The RICE method of self-care:
    • Rest your ankle
    • Ice it to keep swelling down
    • Compress your ankle with bandages to immobilize and provide support to your injury
    • Elevate your ankle above your heart level for 48 hours
  • Short leg cast or a walking boot, and most commonly an ankle brace

Repeated ankle sprains may require surgery to tighten the ligaments.

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