Ankle Sprain

What is an ankle sprain?

Ankle sprains are common injuries in sports. With an ankle sprain, the ligments in the ankle are injured. Ligaments are strong bands that connect the bones within the ankle. The most common ankle sprain is an “inversion” ankle sprain which occurs when the foot is “rolled” inward allowing the lateral ankle ligaments to stretch or tear. The anterior talofibular ligament is the most commonly injured ligament.

Who gets an ankle sprain?

An ankle sprain occurs commonly in sports, but can also occur if someone steps wrong, especially while walking on an uneven surface. Athletes who have had previous ankle sprains are more likely to have subsequent ankle sprains, especially if they were not rehabbed adequately.

How is an ankle sprain diagnosed?

Ankle sprains are typically diagnosed by history and physical examination. Your physician will generally ask how your injury occurred and examine your ankle. The ankle is typically swollen and bruised. There is significant tenderness over the ankle ligaments, with less tenderness over the bones. Depending on the amount of pain you are in, the physician may check the “looseness” of your ligaments with special tests on his or her exam. X-rays may be obtained to rule out a fracture. In most cases, if you are able to walk on your injured ankle, a fracture is unlikely.

What is the treatment for an ankle sprain?

Treatment for ankle sprains occurs in 3 phases:

Phase 1: Typically known as R-I-C-E which stands for rest, ice, compression, and elevation. This treatment will help to reduce pain and swelling. During this time, an athlete should not participate in sports or other physical activities. He or she should ice the ankle and can wear a light compression wrap, which along with elevation will help to decrease or minimize the swelling. At this point, the athlete should also work on gentle range of motion exercises to prevent the ankle from getting stiff. In most cases of ankle sprains, the athlete may bear weight on the injured ankle as tolerated. Sometimes, crutches are needed for a few days.

Phase 2: In the second phase, strengthening exercises should begin. These are usually done with bands and work on strengthening the muscles around the ankle in all direction (Illustration: dorsiflexion, plantarflexion, inversion and eversion). You should continue to ice the ankle if swelling persists.

Phase 3: In the third phase, exercises are done to help prevent future ankle sprains. Proprioception exercises which include balance exercises help with this. When the ankle is injured, small receptors in the ankle ligaments are injured which can delay the signal from the brain telling the foot to plant normally on the ground when you are running or landing from a jump. This delay can cause you to sprain your ankle again. Proprioception exercises help to decrease this delay so that you are at less risk for a future injury.

Upon returning to sports, your physician may recommend use of an ankle brace. This is not a substitute for a good rehab program following an ankle sprain. A lace-up ankle brace, however, has been shown to provide better stability for an ankle than taping.

Surgery is rarely indicated for an ankle sprain. If an athlete has had recurrent ankle sprains and significant laxity, or looseness, in the ligaments following an extensive rehab program, surgery may be considered to tighten or reconstruct the injured ligaments.