Ankle Sprain

An ankle sprain is a tear in the ligaments of the ankle. It can happen when you simply step on an uneven surface, or step down at an angle. The most common ankle sprain occurs on the lateral or outside part of the ankle. When the foot twists, rolls or turns beyond its normal motions, a great force is transmitted upon landing. This causes the ligaments to stretch beyond their normal range in an abnormal position. 

Grade of the sprain

  • Grade 1 sprain: Slight stretching and some damage to the fibres (fibrils) of the ligament.
  • Grade 2 sprain: Partial tearing of the ligament. If the ankle joint is examined and moved in certain ways, abnormal looseness (laxity) of the ankle joint occurs.
  • Grade 3 sprain: Complete tear of the ligament. If the examiner pulls or pushes on the ankle joint in certain movements, gross instability occurs.

What are the symptoms of an ankle sprain?

  • Ankle pain, which can be mild to severe
  • Swelling and bruising around the ankle
  • A popping sound during the injury
  • Difficulty moving the ankle
  • Cannot put any weight on the injured foot
  • Weakness or instability in the ankle
  • Instability of the ankle (in severe sprains)

What are the risk factors for an ankle sprain?

  • Previous ankle sprains
  • Walking, running, or playing on uneven surfaces
  • Wearing shoes that don’t fit well or don’t have good support
  • People with a rear foot varus, where the general nature or posture of the heels is slightly turned toward the inside.
  • Playing sports that require sudden changes in direction, like football, soccer, and basketball

How is an ankle sprain diagnosed?

  • Ankle sprains can be diagnosed fairly easily given how common the injury is.
  • An X-rays and ultrasound will indicate that the ankle ligaments have been torn or sprained.
  • It is very important not to assume any injury as an ankle sprain as other injuries can occur such as a tear in the peroneal
  • In very severe cases, an MRI may be needed to rule out other problems in the ankle such as damage to the cartilage.
  • Chronic instability can occur in patients who sprain their ankle repeatedly, which can be dangerous as it can lead to damage to the ankle joint

Treatment Options

  • Surgery is not required in the vast majority of ankle sprains.
  • An important fact to remember is the patient’s ability to bear weight on the injured foot. Patients who can bear on the foot are likely to recover in a short period of time.
  • Resting and icing the ankle sprain for 20 minutes every two to three hours is advised in the first 48 to 72 hours after the injury occurs.
  • Patients who cannot bear weight on the foot are better treated in a removable walking boot until they can comfortably bear weight on the foot.
  • Patients can be taught to strengthen the muscles around the ankle.