Almost everybody, at some point in their lives will experience the pain and frustration of a twisted ankle. And you’ll struggle with questions like “Is it broken or just sprained?” “Should I go to the doctor or just ice it?” “How am I gonna go to work, or play in the game, tomorrow?” The challenging part about ankle injuries is they vary a lot. It’s easy to find out if it’s broken or not. But sometimes it’s not as easy to determine the severity of your injury if it’s not just a break. Some ankle injuries are mild and get better almost on their own. The hard part is determining if your ankle sprain is mild or not. This is difficult for everyone.
An ankle sprain often happens after a twist injury, people often hear or feel a “pop”, have pain, swelling, and have a hard time putting weight on that leg. Often an examination by a medical provider and x-rays are needed to tell if the ankle is sprained or fractured. Occasionally an MRI is needed to look for additional problems such as a small bone chip or injury to the joint surface.
What is an Ankle Sprain?
About 25,000 ankle sprains occur every day. These occur in both athletes and non-athletes, children and adults. A sprained ankle involves injury to one of the firm rubber band type structures (ligaments) that hold the bones together at the ankle. When a ligament is forced to stretch beyond its normal range, a sprain occurs. These injuries typically occur after twisting/rolling/turning the foot or ankle.
The extent of the injury is graded by the examiner based on the amount of injury to the ligament.
Grade 1 sprain: slight stretching and mild damage to the fibers of the ligament.
Grade 2 sprain: partial tearing of the ligament, on exam there is looseness (laxity) of the ankle.
Grade 3 sprain: complete tear of one or more ligaments. When that ligament is stressed it provides no support and is very loose (laxed).
What are the Symptoms of an Ankle Sprain?
When you sprain your ankle you may notice your ankle or foot moving beyond its normal motion. People often describe it as twisting or rolling and some people report hearing or feeling a “pop”. After the initial injury you may experience pain, swelling, stiffness, weakness, and difficulty putting wait on that foot. Walking can be difficult or impossible.
What Treatment is needed for a Sprained Ankle?
The treatment of this injury depends on how severely the ligament is injured and which ligament is injured. Most ankle sprains can be treated without surgery. Treatment is broken down into three phases and the duration of each phase is dependent on the extent of the injury.
Phase 1 includes resting, protecting the ankle and reducing the swelling. This may include ice, elevation, compression wrap, crutches, splint, cast, and/or a boot.
Phase 2 includes restoring normal motion and strength to the ankle. This may require physical therapy or a home exercise program.
Phase 3 includes gradual return to activities such as exercise and sports. This phase often requires maintenance exercises. Some people require physical therapy to fully recover from their injury and others can do a home exercise program.
If an ankle sprain is not recognized, and is not treated with the necessary attention and care, chronic problems of pain and instability may result. Surgery is rarely needed for ankle sprains and is typically reserved for injuries that fail to respond to nonsurgical treatment.
What should I know?
Ankle sprains are common and the important message here is that early evaluation and intervention by a medical provider can expedite recovery and reduce the risk of long term problems. Let us take good care of you at the Orthopedic Institute at Southwest Health.
Phil Burr, PA-C
Certified Physician Assistant
Orthopedic Institute at Southwest Health (608) 342-4748