Ankle Sprain

An ankle sprain is a partial or complete tear of the ligaments that support the ankle. Ligaments are strong bands of tissue that cross joints and connect bones to each other.

Ankle sprains may be caused by:

• Sudden twisting of the ankle, such as:
  • Having your ankle "roll over" when playing sports or exercising (called inversion of the foot)
  • Stepping on an uneven surface or in a hole
  • Taking an awkward step when running, jumping, or stepping up or down
• Falling

A risk factor is something that increases your chance of getting a disease or condition. In this case, these include:

• Having:
  • Inadequate strength in muscles and tight ligaments
  • Loose joints
  • Poor balance
  • Poor coordination
• Playing sports

When you have a sprained ankle, you will likely have:

• Inability to move the ankle joint without pain
• Pain, swelling, and bruising around the ankle
• Popping or tearing sound at the time of the injury (possibly)
• Worsening of pain when walking, standing, pressing on the sore area, or moving the ankle inward

An ankle sprain may not require a visit to the doctor. However, you should call your doctor or visit an emergency room if you have:

• Inability to move the ankle without significant pain
• Inability to put any weight on that foot
• Numbness in the leg, foot, or ankle
• Pain not relieved by ice, pain relief medication, and elevation
• Pain over a bony part of your foot or ankle
• Pain that does not improve in 5-7 days
• Pain that interferes significantly with walking
• Uncertainty about how to care for this injury
• Uncertainty about the severity of the injury

The doctor will:

• Ask about your symptoms and how the injury occurred
• Examine your ankle to assess the severity of the injury

Tests may include:

• MRI scan —to see if a ligament has torn completely (rarely needed)
• X-rays —to make sure that no bones are broken

Ankle sprains are graded according to the damage to the ligaments. The more ligaments involved, the more severe the injury.

Treatment for a sprained ankle includes:

• Medication—Take one of the following drugs to help reduce inflammation and pain:
  • Acetaminophen (Tylenol)
  • Aspirin
  • Ibuprofen (Motrin, Advil)
  • Naproxen (Aleve, Naprosyn)
• Brace—You may need to wear a brace to immobilize your ankle. In many instances, a brace, which stabilizes and compresses the ankle, will allow for early weight bearing and an earlier return to activity. You will be rehabilitating the ankle as it heals. If you play sports, you may need to wear an ankle brace or tape your ankle when you return to play.
• Compression—Wrap your ankle in an elastic compression bandage (eg, Ace bandage). Wrap from the toes going up toward the knee. This will limit swelling of your ankle and foot.
• Elevation—Keep your ankle raised above the level of your heart as much as you can for 48 hours. This will help drain fluid and reduce swelling.
• Ice—Apply ice or a cold pack to the ankle for 15-20 minutes, four times a day for at least 2-3 days. This helps reduce pain and swelling. Wrap the ice or cold pack in a towel. Do not apply the ice directly to your skin.
• Leg cast—A cast is very rarely needed for an ankle sprain. If you have a severe sprain, your doctor may recommend a short leg cast for 2-3 weeks, but this is very rare. In many cases, there are special braces that can be used instead of a cast.
• Rehabilitation exercises—Begin exercises to restore flexibility, range of motion, and strength of the muscles around your ankle as recommended by your health care professional.
• Rest—Avoid putting any pressure on your ankle by not walking on it. Using crutches will allow for partial weight-bearing. This is allowed, early on, except in three ligament tears.
• Surgery—Surgery is rarely needed to repair an ankle sprain, but it may be necessary to repair a third degree sprain in which all three ligaments are torn.

If you are diagnosed with an ankle sprain, follow your doctor's instructions .

Many ankle sprains cannot be prevented. However, you can reduce your risk of spraining an ankle:

• Do exercises that strengthen leg and foot muscles.
• If you have injured your ankle before, you are much more likely to injure it again. You may reduce your risk of repeated sprains by wearing an Air-Cast or other ankle brace.
• Learn the proper technique for exercise and sporting activities. This will decrease stress on all your muscles, ligaments and tendons, including those around your ankle.
• Take a break from sports or exercise when you feel tired.