What is an ankle sprain?
Most people have twisted
an ankle at some point in their life. But if your ankle gets swollen and
painful after you twist it, you have most likely sprained it. This means you
have stretched and possibly torn the
ligaments in your ankle.
Even though ankle sprains are common, they are not
always minor injuries. Some people with repeated or severe sprains can develop
long-term joint pain and weakness. Treating a sprained ankle can help prevent
ongoing ankle problems.
What causes ankle sprains?
Most types of ankle sprains
happen when you make a rapid shifting movement with your foot planted, such as
when you play soccer or get tackled in football. Often the ankle rolls outward
and the foot turns inward. This causes the ligaments on the outside of the
ankle to stretch and tear. Less often, the ankle rolls inward and the foot
turns outward. This damages the ligaments on the inside of the ankle.
An ankle sprain can range from mild to
severe, depending on how badly the ligament is damaged and how many ligaments
are injured. With a mild sprain, the ankle may be tender, swollen, and stiff.
But it usually feels stable, and you can walk with little pain. A more serious
sprain might include bruising and tenderness around the ankle, and walking is
painful. In a severe ankle sprain, the ankle is unstable and may feel "wobbly."
You can't walk, because the ankle gives out and may be very painful.
What are the symptoms?
With most sprains, you
feel pain right away at the site of the tear. Often the ankle starts to
swell immediately and may bruise . The ankle area is usually tender to touch,
and it hurts to move it.
In more severe sprains, you may hear
and/or feel something tear, along with a pop or snap. You will probably have
extreme pain at first and will not be able to walk or even put weight on your
foot. Usually, the more pain and swelling you have, the more severe your ankle
sprain is and the longer it will take to heal.
How is an ankle sprain diagnosed?
Your doctor will
ask you how the injury occurred and if you have hurt your ankle before. He or
she will check your foot and ankle, your lower leg, and even your knee to see
if you are hurt anywhere else.
If the sprain is mild, your doctor
may not order
X-rays. But with more severe sprains, you may need
X-rays to rule out a broken bone in the ankle or the foot. It is possible to
break a bone in your foot or ankle at the same time as a sprain.
In most cases, doctors order X-rays in children with symptoms of an ankle
sprain. This is because it is important to find and treat any damage to the
growth plates in bones that support the ankle.
How is it treated?
In many cases you can first use
the PRINCE approach to treat your ankle:
- Protection. Use a
protective brace, such a brace with a built-in air cushion or another form of
- Rest. You may need to use crutches until you can walk without pain.
- Ice. For at least
the first 24 to 72 hours or until the swelling goes down, apply an ice pack for
10 to 20 minutes every hour or two during the day. Always keep a thin cloth between the ice and your skin, and press the ice pack firmly against all the curves of the affected area.
- NSAIDs or acetaminophen.
NSAIDs (such as Advil and Motrin) are medicines that
reduce swelling and pain. Acetaminophen (such as Tylenol) reduces pain.
- Compression. An elastic
compression wrap, such as an ACE bandage, will help reduce swelling. You wear
it for the first 24 to 36 hours. Compression wraps do not offer protection. So
you also need a brace to protect your ankle if you try to put weight on
- Elevation. Raise your ankle above the
level of your heart for 2 to 3 hours a day if possible. This helps to reduce
swelling and bruising.
Proper treatment and rehabilitation (rehab) exercises are very
important for ankle sprains. If an ankle sprain does not heal right, the joint
may become unstable and may develop
chronic pain. This can make your ankle weak and more
likely to be reinjured. Before you return to sports and other activities that
put stress on your ankle, it's a good idea to wait until you can hop on your
ankle with no pain. Taping your ankle or wearing a brace during exercise can
help protect your ankle. Wearing hiking boots or other high-top, lace-up shoes
for support may also help. But use caution. Don't force your foot into a boot
if you feel a lot of pain or discomfort.
If your ankle is still
unstable after rehab, or if the ligament damage is severe, your doctor may
recommend surgery to repair the torn ligaments.
What kind of rehabilitation program should you follow?
Rehab exercises can begin soon after the injury. You can try to walk or
put weight on your foot while using crutches if it doesn't hurt too much.
Depending on your pain, you can also begin
range-of-motion exercises while you have ice on your
ankle. These exercises are easy to do—you just trace the alphabet with your
toe. This helps the ankle move in all directions.
Ask your doctor
about other rehab. Stretching, strength training, and balance exercises may
help the ankle heal totally and may prevent further injury.