About Sprained Ankle
An ankle sprain is a common injury that occurs when the ligaments surrounding the ankle joint are stretched or torn. Ligaments are tough bands of tissue that connect bones and provide stability to the joint. An ankle sprain typically happens when the ankle is twisted or turned in an awkward way, causing the ligaments to exceed their normal range of motion. This can result in pain, swelling, and difficulty moving the ankle. Ankle sprains are often classified into three grades based on the severity of ligament damage:
- Grade I: Mild sprain with minimal ligament damage and little loss of function
- Grade II: Moderate sprain with moderate ligament damage and some joint looseness
- Grade III: Severe sprain with complete ligament tear and significant joint instability
It is important to seek medical attention for an ankle sprain to determine the extent of the injury and receive appropriate treatment.
The underlying causes of ankle sprains include:
- Sudden or unexpected movement during physical activity, leading to inward twisting of the ankle
- Walking or running on uneven surfaces
- Participating in sports that involve rolling or twisting of the foot, cutting actions, or jumping and landing forcefully
- Previous ankle sprain, which increases the likelihood of future sprains if the ligaments do not fully heal
Non-modifiable risk factors for sprained ankle, which are factors that cannot be influenced or changed include:
- Age: Younger people, especially teens and young adults, are more likely to sprain their ankles due to being more active in sports.
- Gender: Females tend to have a higher risk of ankle sprains compared to males.
- Abnormal feet anatomy: Some individuals may have abnormal feet anatomy, such as having high arches, that makes their ankle joint more likely to sprain.
- Genetics: If you have a family history of ligament laxity (loose joints), you might be at a higher risk for ankle sprains.
- Previous injury: If you’ve sprained your ankle before, you’re more likely to sprain it again due to lingering weakness or instability.
Modifiable risk factors for sprained ankle can be influenced or changed. These include:
- Muscle strength: Weak muscles around the ankle increase the risk of sprains.
- Warm-up and stretching: Not warming up before physical activity can make injuries more likely.
- Activity level: Jumping into high-intensity sports or activities without proper conditioning can increase the chance of injury.
- Improper footwear: Wearing inappropriate shoes that do not provide sufficient support or stability for the ankles
- Poor balance: Poor balance and situational awareness can contribute to ankle instability and increase the likelihood of sprains
It's important to note that these risk factors may vary from person to person, and individual circumstances should be considered. Consult with your healthcare professional for personalized advice.
The most common early symptoms of an ankle sprain include:
- Ankle pain
- Tenderness
- Swelling
- Bruising
- Trouble moving the ankle
- Inability to put full weight on the ankle
As the ankle sprain progresses or becomes more severe, additional symptoms may occur, such as:
- Discoloration of the skin around the ankle
- Limited range of motion
- Stiffness
- Instability that makes it difficult to walk or causes the ankle to give out or collapse when walking
- Sudden pain, usually after a fall or blow, which may become worse over several hours
- A popping sound following the injury (in severe cases)
It's important to note that a severe sprain may feel like a broken bone and the symptoms may be similar to a fracture, including difficulty moving the joint. If you experience intense muscle or bone pain following an injury, it is recommended to see a doctor for evaluation and appropriate management.
To diagnose an ankle sprain, doctors commonly perform the following examinations, tests, and procedures:
- Physical exam: Your doctor will assess your ankle by moving it in various ways to check your range of motion and determine which ligaments have been torn.
- Imaging tests: X-rays may be ordered to rule out a bone fracture. An MRI (magnetic resonance imaging) scan may be done if there is suspicion of a fracture, serious ligament injury, or damage to the ankle joint's surface.
To determine the stage or severity of an ankle sprain, additional examinations, tests, and procedures may include:
- Ultrasound examination: Ultrasound is a useful tool for accurately diagnosing foot and ankle injuries. It can examine the joints and ligaments in the foot, including:
- The midtarsal joint: Connects the front and back parts of the foot
- The syndesmotic ligament: Stabilizes the bones of the lower leg near the ankle
- The anterior talofibular ligament (ATFL): A common site of injury that connects the ankle bone to the fibula (the smaller bone in the lower leg)
- The calcaneofibular ligament (CFL): Connects the heel bone to the fibula and helps stabilize the ankle
- Squeeze test: The doctor squeezes your leg under the knee. If pain spreads down to the ankle area, it can indicate a high ankle sprain.
- External rotation test: The doctor asks you to bend your knee and slowly turns your foot away from the body. Pain in the ankle during this test can suggest a high ankle sprain.
Remember, each individual's diagnosis may vary. Consult with your healthcare professional for personalized advice.
The goals of treatment for ankle sprains are as follows:
- Control acute inflammation: This is achieved through the use of medications such as nonsteroidal anti-inflammatory drugs (NSAIDs), which help reduce pain and swelling.
- Relieve pain: Over-the-counter pain relievers like acetaminophen or NSAIDs can be used to manage pain associated with ankle sprains. These medications work by blocking pain signals in the body.
- Regain full ankle range of motion (ROM): Physical therapy plays a crucial role in helping patients regain their full range of motion. Therapists may recommend exercises that focus on stretching and strengthening the muscles around the ankle joint.
- Return to pre-injury level: Rehabilitation programs, supervised by a physical therapist, help individuals recover faster and regain their previous level of activity. These programs include exercises that rebuild strength, balance, and confidence in the ankle.
- Increase muscle strength and power: Strengthening exercises prescribed by a physical therapist aim to improve muscle strength and power around the ankle joint, reducing the risk of reinjury.
- Prevent recurrence of injury: By improving muscle strength, balance, and coordination, rehabilitation programs help prevent future ankle sprains.
Additional treatments for ankle sprains may include:
- Using a plaster cast or splint to keep the injured area from moving so it can heal properly
- Functional conservative treatment with tape, a semi-rigid brace, or a lace-up brace, along with coordination exercises to help recovery
- Complementary and alternative therapies such as herbal remedies, massage, and acupuncture (limited evidence)
It's important to note that medication types and therapies should be discussed with a healthcare professional before use.
Medication dosing may be affected by many factors. Check with your health care professional about dosing for your individual situation. Side effects can occur. Check with your health care professional or read the information provided with your medication for side effect information.