Sprained Ankle

A sprained ankle is a soft tissue injury involving trauma to the ligaments of the ankle. The severity of this injury can range from a grade 1 strain (consisting of mild overstretching of the structure or microscopic tearing) to a grade 3 strain (consisting of a complete rupture and usually accompanied by joint instability). In the most severe cases (e.g. inability to put any weight on the ankle), a sprain may be accompanied by a fracture. Typical symptoms of a sprained ankle are pain, swelling and tenderness. In most cases, a sprained ankle can be treated at home, using R.I.C.E. procedures and pain relief medication (see below). However, in a few cases, the severity of the injury may prompt a doctor to suggest more invasive procedures.

This is one of the most common soft tissue injuries out there. It is by no means associated only with sports activity. In colder climates, many people suffer ankle sprains walking on icy or snowy surfaces or while clearing snow from their homes, for instance.

Types Of Ankle Sprain

Sprains can involve either the inner or outer ligaments. A medial sprain involves damage to the ligaments on the inside of the joint (nearer to the centre of the body). A lateral sprain involves ligaments on the outer side. Most sprains involve ligaments on the outside of the joint (lateral sprains). These occur when the ankle is rolled inwards. See the diagram at the start of this article for an illustration of how this happens.

High Ankle Sprains

A special subcategory of sprains includes those involving ligaments above the ankle itself. This type of sprain is known as a high ankle sprain and typically occurs among athletes, especially those in contact sports like hockey. In many cases, this type of sprain is accompanied by a fracture of the joint itself.

Causes

Typical events that can give rise to an ankle sprain include:

• Falling awkwardly in a way that causes the ankle to twist while you are off balance;
• Landing awkwardly after a jump and twisting the ankle while trying to recover your balance;
• Walking, running or exercising on a rocky or unstable surface. In these circumstances, the ankle can be twisted when the patient inadvertently steps on the side of a rock while walking or running (for example).

In some cases, an individual who has suffered a sprain in the past is more likely to experience one again. So, the above situations are even more likely to cause a sprain for such an individual. Wearing shoes that don’t provide proper support or that make it more likely to “roll” the ankle will also predispose someone to an ankle sprain.

An injury of this type should be handled carefully to ensure that the patient recovers fully before restarting regular activities. Otherwise, the ankle ligaments could be permanently weakened, leading to long term ankle instability or even ankle arthritis.

Prevention & Treatment

How To Prevent Or Reduce The Risk Of A Sprain

To reduce the risk of suffering an ankle sprain, individuals can take the following precautions:

• Warm up and stretch properly before commencing any athletic activity. The warmer your joints are, the more supple your ligaments will be. If, the less likely these ligaments are to be torn or overstretched if something happens.
• Avoid exercising or playing on uneven surfaces as much as possible;
• If you have previously suffered an ankle sprain, use an ankle brace or athletic tape to give the joint additional support;
• If you play a sport in which falls are common, you can get coaching in falling or running when off balance. This will reduce the risk of incurring an ankle sprain when you are doing these things.

Treatment Of Ankle Sprains

In most cases, an ankle sprain can be treated at home using conservative R.I.C.E. procedures, as follows:

• Rest – keep the weight off the ankle as much as possible. If the patient needs to move around, he or she should consider using crutches or a wheelchair;
• Apply Ice to the ankle every 15 to 20 minutes for the first day or two after suffering the injury;
• Apply Compression to the injury using an elastic bandage. If this causes numbness or a loss of feeling anywhere (including away from the ankle), the bandage may be interfering with circulation. If so, the bandage should be removed immediately and a doctor consulted;
• Whenever possible, keep the ankle Elevated above heart level.