Ankle Sprains & Treatments Available
Ankle sprains are common injuries that happen when the ligaments supporting the joint are overstretched or torn. Sprained ankles often result from sudden twisting or rolling movements of the foot, making them a frequent occurrence in sports and everyday activities. Timely diagnosis and treatment, which may involve seeking help from a doctor, are crucial for potentially preventing long-term complications like chronic pain or instability.
What is an Ankle Sprain?
An ankle sprain is an injury to one or more ligaments in the ankle, typically caused by the foot twisting, rolling, or moving awkwardly. This can result in the ligaments being stretched or torn. There are different types of ankle sprains, categorised by the direction of the ankle’s movement and the ligaments involved.
Inversion Sprain
An inversion sprain is the most common type of sports injury, occurring when the ankle rolls inward, damaging the ligaments on the outer side of the ankle. The anterior talofibular ligament (ATFL) and the calcaneofibular ligament (CFL) are the most commonly injured ligaments in this type of sprain.
Eversion Sprain
An eversion sprain happens when the ankle rolls outward, injuring the ligaments on the inner side of the ankle, such as the deltoid ligament. This type of sprain is less common than inversion sprains.
High Ankle Sprain
A high ankle sprain involves injury to the syndesmotic ligaments, which connect the tibia and fibula (the two bones of the lower leg) above the ankle joint. These sprains often occur due to forceful twisting or rotational injuries.
Symptoms of an Ankle Sprain
Ankle sprains present with various symptoms, depending on the severity of the injury. Common symptoms include:
- Pain at the ligament tear site.
- Swelling and bruising immediately after injury.
- Tenderness when touched.
- Difficulty bearing weight or walking.
In some cases, such as severe sprains with complete ligament tears, individuals may experience:
- A “pop” or “snap” sound.
- Visible deformity or intense pain.
- Marked swelling and bruising around the ankle.
Causes and Risk Factors
Ankle sprains can happen as result of a variety of movements and accidents, including:
- Sudden changes in movement during sports (e.g., soccer, basketball).
- Landing awkwardly after jumping.
- Walking or running on uneven ground.
Additionally, several factors can increase the risk of ankle sprains:
- Poor muscle strength and conditioning.
- History of previous ankle sprains.
- Inadequate footwear or lack of warm-up before activities.
Grading of Ankle Sprains
Ankle sprains are assessed and graded based on the severity of ligament damage. This grading system helps determine treatment decisions and provides an indication of the expected recovery time:
- Grade I: Mild ligament stretching; minimal pain and swelling.
- Grade II: Partial tear with moderate pain, swelling, and bruising; difficulty walking.
- Grade III: Complete ligament tear; severe pain, swelling, bruising, and inability to walk.
Diagnosis of Ankle Sprains
When you visit a doctor for a sprained ankle, they will perform a thorough evaluation to diagnose the injury and determine its severity. This assessment helps guide treatment decisions and ensures appropriate care.
Clinical Examination
When addressing a sprained ankle, the doctor will usually begin by conducting a clinical examination, which may include:
- Assessing swelling, bruising, and ankle stability.
- Checking for tenderness and comparing both ankles.
- Evaluating the range of motion and pain levels.
Imaging Tests
In some cases, further tests may be needed to confirm the grading and rule out other injuries. Common tests for sprained ankles include:
- X-rays: To rule out fractures or bone abnormalities.
- MRIs: For severe sprains or recurrent injuries to evaluate ligament tears or other soft tissue damage.
Treatment Options for Ankle Sprains
Treatment for ankle sprains mainly depends on the severity of the injury and individual needs. Options range from self-care measures to surgical intervention in severe cases.
Immediate Self-Care (RICE Method)
The RICE method is crucial for initial sprained ankle treatment, especially within the first 24 – 48 hours. It helps reduce inflammation and pain and promotes healing. The steps include:
- Rest: Avoid weight-bearing; use crutches if necessary.
- Ice: Apply for 15 minutes every 4 hours to reduce swelling.
- Compression: Use elastic bandages or braces for support.
- Elevation: Keep the foot above heart level to minimise swelling.
Immobilisation
In more severe cases, an Air Boot or a cast may be applied to immediately immobilise the ankle and support the weightbearing. Inadequate immobilisation for more severe ankle sprains may lead to a higher rate of subsequent re-sprains.
Medications
Your doctor may recommend over-the-counter pain relievers and anti-inflammatoriesn to manage pain and inflammation for sprained ankles. In some cases, prescription-strength anti-inflammatory drugs or pain medications may be necessary.
Physiotherapy and Rehabilitation
Physiotherapy is a crucial component of sprained ankle treatment. The goal of physiotherapy is to eventually restore strength, flexibility, and stability to the sprained ankle. Physiotherapy could be suitable for cases of milder sprains. It also focuses on balance and proprioception exercises to prevent future injuries. Common physiotherapy exercises for ankle sprains include:
- Static resistance exercises using the patients’ own hand.
- Balancing on uneven surfaces eg the wobble board.
- Single leg squats
- Progressive resistance training.
Injection Treatments
For appropriate cases, usually involving partial tears or mild laxity of the ankle, a biological treatment using the patient’s own blood can be done to stimulate healing and new growth of the injured ligament tissue. This tends to be more effective than pure conservative treatment as it directly stimulates healing.
Surgical Treatments
While milder ankle sprains heal with conservative treatment, ankle surgery may be necessary in some cases. For persistent pain or instability that doesn’t respond to non-surgical sprained ankle treatment, or for severe injury cases involving full tears of the ligament, your doctor might recommend surgical intervention. This could involve:
- Arthroscopic (keyhole) surgery to reconstruct damaged cartilage.
- Mini-Open surgery to repair or reconstruct torn ligaments.
- Use of plastic screws (suture anchors) to reattach ligaments to bones.
Post-surgery recovery involves immobilisation with a cast for a week, then conversion to a walking Air Boot, and physiotherapy for 6 – 8 weeks to allow the repaired ligaments to heal properly and regain ankle function. This post-operative treatment helps prevent re-injury and ensures long-term stability. Importantly, the lateral ankle ligaments have a very high recovery rate once they are repaired in a stable way.
Recovery Timeline and Extent of Recovery
The recovery timeline for a sprained ankle can vary significantly depending on the severity of the injury (grade of the sprain), individual healing factors, and adherence to treatment recommendations. In general, the expected recovery times are:
- Grade I: 1 – 3 weeks.
- Grade II: 3 – 6 weeks.
- Grade III: 6 weeks or longer, with possible surgery.
Importantly, higher grades of injuries will likely have a poorer extent of recovery compared to lower grades of injuries. However, adhering to rehabilitation programs and following your doctor’s advice are crucial for restoring ankle function and preventing long-term complications. This includes diligently performing prescribed exercises, attending physiotherapy sessions, and gradually increasing activity levels as advised.
Prevention of Ankle Sprains
Preventing ankle sprains is vital for maintaining ankle health and avoiding disruptions to daily activities and sports participation. Here’s what you can do to reduce your risk:
- Warm up adequately before sports or exercise.
- Wear appropriate footwear and ankle supports.
- Strengthen ankle and leg muscles through regular strengthening-type exercises.
- Avoid activities on uneven surfaces if not conditioned.
When to See a Specialist
Prompt medical evaluation is crucial for proper sprained ankle treatment and to rule out more serious injuries. See a doctor for a sprained ankle if you experience any of the following:
- Severe pain or inability to bear weight.
- Visible deformity or severe swelling.
- Persistent instability or recurrent sprains.
- Lack of improvement after a week of self-care.
Frequently Asked Questions About Ankle Sprains
How long does it take to recover from an ankle sprain?
Recovery time for a sprained ankle varies depending on the severity (grade) of the sprain and individual healing factors. Mild sprains could heal within a few weeks, while severe ankle sprains could take several months. Only a doctor can assess the severity and recommend appropriate treatment and rehabilitation strategies to facilitate a faster recovery.
Can I walk on a sprained ankle?
This depends on the severity of the injury. For mild ankle sprains, walking may be possible with minimal discomfort. However, for moderate to severe sprains, walking may be painful and could cause further damage to the ligaments. Pain level varies from person to person and may not be a reliable indicator of how serius the injury actually is. It’s essential to consult a doctor or ankle specialist to determine the appropriate level of weight-bearing and receive guidance on the appropriate treatment.
Do I need surgery for a sprained ankle?
Again, it depends on the severity of your sprain. In milder cases, surgery is rarely needed as most sprains can heal satisfactorily with conservative sprained ankle treatment. However, surgery may be utilised in cases of severe ligament tears, or cases that result in recurrent or chronic ankle instability.
Is surgery only needed for severe ligament tears or chronic instability?
While surgery is more commonly needed for severe ligament tears or chronic instability resulting from an ankle sprain, there may be other instances where a doctor may recommend surgical intervention. These may include cases with associated injuries like fractures or cartilage damage or when conservative sprained ankle treatment fails to provide adequate relief and restore ankle function.
See an Ankle Sprain Specialist Today
If you have suffered an ankle sprain or are experiencing chronic ankle pain that limits your daily activities or prevents you from enjoying your favourite sports, it’s crucial to seek the advice of a doctor. Early intervention and proper diagnosis could significantly improve outcomes and potentially facilitate a faster return to your normal activities. Schedule a consultation with an ankle specialist today.