Ankle Sprains

Ankle sprains are the most commonly seen sports injuries; however, ankle sprains can happen among people of all ages and activity levels.

Ankle Sprains

Ankle sprains are the most commonly seen sports injuries; however, ankle sprains can happen among people of all ages and activity levels. When the term “sprain” is used, it refers to an injury to a ligament, the tough fibrous connective tissue found between two bones.  There are many ligaments around the ankle joint that help with motion and stability. When one of these ligaments around the ankle are injured, bleeding and swelling occur.  This is the body’s response to heal an injured area. Ankle ligaments often do heal on their own due to the increased blood that travels to the area. Swelling and bruising are usually more pronounced at the ankles due to this response with the distance of the ankles from the heart can cause the ankles to remain swollen for prolonged periods following the injury. Ankle sprains are graded – most mild to moderate ankle sprains (Grade 1 and Grade 2 respectively) can be treated at home with the RICE protocol (rest, ice, compression and elevation) and NSAIDs (nonsteroidal anti-inflammatory drugs). You should see your doctor if the sprain is severe (Grade 3), the pain is severe when bearing weight or you can’t walk at all.  Nonsurgical treatment is commonly implemented first, often using a brace or a CAM boot to immobilize the joint appropriately and allow for adequate healing. If extensive tearing of the ligament(s) is expected after a clinical exam, an MRI may be ordered. The American Academy of Orthopaedic Surgeons suggests a three-phase program for all ankle sprains when treated conservatively:

  • Phase 1: resting, protecting the ankle and reducing the swelling.
  • Phase 2: restoring range of motion, strength and flexibility. Physical therapy is often utilized here to prevent stiffness and increase ankle strength.
  • Phase 3: maintenance exercises and the gradual return to activities that do not require turning or twisting the ankle. Eventually, activities that require more intense activities that require sharp, sudden turns (i.e. tennis, basketball) can be reintroduced.

The length of this treatment program may take just 2 weeks to complete for minor sprains, or up to 6 to 12 weeks for more severe sprains. Surgical treatment for ankle sprains is rare, however sometimes necessary for severe injuries that fail to respond to nonsurgical treatment. High ankle sprains (also known as syndesmotic injuries) sometimes require surgical intervention with a “tightrope” or a screw if the syndesmotic joint (joint found between the tibia and fibula) is found to be unstable. As with many other conditions, prevention is the best way to avoid ankle sprains.  This includes using caution when walking or running on uneven surfaces, wearing proper footwear, and implementing a thorough warm up and stretching regimen before and after physical activity.

Ankle Sprains

(Courtesy: www.aaos.org)

The arrows indicated a twisting of the foot and ankle causing an ankle sprain. The ligaments to the outside of the ankle are the most common to be injured in ankle sprains.

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Every patient receives an in-depth consultation to devise a treatment plan that is right for their problem. Our specialists prefer non-operative and non-invasive treatments whenever possible, including physical therapy, medications, and/or injections. When we require surgery, we will then use minimally invasive surgical techniques to fix your problem, whether it is fixing a broken bone or repairing a tendon. Our goal is always to get you back to living your life normally as soon as possible.

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