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Ankle Sprain
By peace | April 9, 2006
Exercises for a sprained ankle
Ankle sprains are the most common musculo-skeletal sports injury, although a sprain may occur unrelated to participation in sports. According to the American Academy of Orthopedic Surgeons, approximately 25,000 people sprain their ankle every day.
Ankle sprain means traumatic lesion to the lateral ankle ligaments. It can be a simple stretching of the ligaments, the most important lesion being a complete rupture. The ankle sprain is the most frequent lesion seen in a pathology centre. 45% of all these injuries occur during sport. For example, a study about basketball players reveals that 76% of them sustained at least 1 ankle sprain. It is true that many of them heal spontaneously without any treatment. For this reason these trauma tend to be neglected as much by the patients as by the non specialist doctors. This is the most frequent cause of chronic post-sprains problems which could have been avoided in the case of an immediate and accurate diagnosis.
Several ligaments help surround the ankle to help provide support. An ankle sprain may involve any number of these ligaments. The most common sprain occurs when the foot is inverted (heel is 
turned inward) and the lateral, or “outside” ligaments are injured. However, ligaments on the inside of the ankle or between the two lower leg bones (called the syndesmosis ligaments) may also be injured with a more severe injury, but these are less common.
Ankle sprains are usually classified as mild, moderate, severe, or involving the syndesmosis. Mild sprains are those that do not affect walking, have minimal swelling, and are not significantly tender to touch. With mild sprains, pain may only be felt when the ankle is put in the position of injury. Moderate and severe ankle sprains involve more swelling, walking with a limp or not being able to bear weight at all.
A severe sprain is more common in those patients who noticed a distinct “pop” and immediate swelling along with an inability to walk. When the syndesmosis ligaments are involved, it is called a “high ankle sprain”. All sprains usually produce bruising that is present all over the ankle, not just on the outside part.
Ankle sprains may be caused by:
- falling
- sudden twisting of the ankle, such as stepping on an uneven surface or in a hole
- inversion of the foot when playing sports or exercising, which causes your ankle to “roll over”
Risk factors that increase your chances of spraining your ankle include:
- playing sports
- poor coordination
- poor balance
- loose joints
Diagnosis of ankle sprain is usually made with a careful history and physical examination. Tenderness in a particular part of the ankle or special exam tests will help your physician determine what ligaments were likely injured. X-rays might be taken to rule out a fracture in the area. Other tests may be ordered by your physician to rule out other conditions that might present in a similar way.
Treatment of ankle sprains usually involves some kind of bracing, such as with an ACE wrap, ankle brace, or sometimes even a cast. Rest, ice, and elevation are used to reduce swelling. The decision of whether or not to weight bear immediately on the ankle will be made by your physician and depends on the severity of the sprain.
Many ankle sprains are not simple injuries, and up to 40% of patients may experience some degree of residual symptoms. It is important to note that recovery time varies with each patient’s injury. Physi
cal therapy, taping/ bracing for sports participation, and/ or wearing supportive shoes may be recommended even after you have been treated. Not treating the ankle sprain or a history of multiple ankle sprains can lead to lax ligaments and chronic ankle instability, pain, and the development of arthritis later.
Minor injuries like sprains may be treated at home if broken bones are not suspected. The acronym RICE is helpful in remembering how to treat minor injuries: “R” stands for rest, “I” is for ice, “C” is for compression, and “E” is for elevation. Pain and swelling should decrease within 48 hours, and gentle movement may be beneficial, but pressure should not be put on a sprained joint until pain is completely gone (one to several weeks).
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