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Training Table | Sprained Ankle

A sprained ankle is commonly seen in both athletes and non-athletes. However, the injury is seen most commonly in sports such as basketball, soccer, tennis and football. The ankle is a collection of bones held in place by their surrounding ligaments. The ligaments are elastic structures which help stabilize joints both statically and in dynamic movements. Due to their elastic nature, the ankle ligaments have a natural stretch and recoil component. When the ligaments are stretched beyond their natural capacity, the ligaments are not capable of returning to original length which results in an injury, also known as a sprain. Depending on the severity of the ankle sprain, there is a possibility for injury to the surrounding structures and tissues of the ankle joint, including the foot and leg bones. If the ankle is repeatedly sprained over a long period of time, typically over six weeks, chronic symptoms may occur. These symptoms may include feeling unstable, lacking strength, poor balance, and the easily giving away with normal daily activities.

An ankle sprain may occur in sport and fitness activities which include running, twisting, cutting, rolling, and quick landing of the foot. As previously stated, spraining your ankle may happen even in daily activities such as walking, climbing stairs, and stepping on uneven surfaces such as curbs or sidewalks. The severity of the sprain is based off a grading scale. A grade 1 sprain has minimal stretching and tearing of the ankle ligaments. Usually, there is minimal tenderness and swelling of the joint.  A grade 2 sprain will have partial tearing of the ankle ligaments with a bit of looseness to the joint. A person with a grade 2 sprain will have moderate tenderness, swelling, and pain to the ankle joint. The person may feel like they cannot move their ankle as well, sense that it is unstable, and may not be able to put full weight on their injured foot. A grade 3 sprain is a complete tear of the ligament with significant swelling and pain. The person will feel that their ankle is highly unstable, extreme difficulty moving their ankle, and will have difficulty placing weight through the injured ankle. In addition, significant bruising may occur to the ankle. 

If an ankle sprain is suspected, it is recommended to see a physician specializing in orthopedic injuries. The physician will evaluate and treat the injured ankle as is needed at that point in time. The evaluation may include an X-ray and/or an MRI depending on the severity of the suspected injury. If the injury requires immediate immobilization, the physician may provide a type of boot and/or crutches in order to alleviate pressure on the ankle with walking.

Treatment for a sprained ankle depends on the grade of sprain and the involvement of any surrounding structures. Usually, the sprained ankle will benefit from a period of rest from excessive activity. The physician may provide basic exercises for early motion and strengthening. In addition, the physician may or may not prescribe pain medication as they feel it is needed. Initially, most cases of a sprained ankle will benefit from rest, icing, compression, and elevation. Icing should be limited to 20 minutes per session, 2-4 times a day. Compression should be enough to prevent further swelling but not promote increased pain. The ankle should be elevated to any level comfortably above your heart. After the initial evaluation, your orthopedic specialist will provide you with the appropriate diagnosis, treatment options, and estimated prognosis for the injury in order to get you back to normal life.

For individuals needing further attention, physical therapy may be beneficial and prescribed by the physician. Physical therapy will benefit an ankle injury by working to restore motion, improving strength, balance, and returning the individual back to their recreational activity, and daily life. Individuals suffering from both an acute and chronic ankle sprain will benefit from physical therapy to improve any problems that may be occurring.

For those individuals that do not experience relief with rest and proper rehabilitation, the physician may find it necessary to perform surgery. This is usually an option for extreme cases and injuries that do not respond well with weeks of rehabilitation. The orthopedic surgeon will evaluate each injury on a case by case basis, the cause of the symptoms, and what surgical technique is needed in order to create stability to the ankle joint.

Ankle sprains can be recurrent if not taken care of properly after the initial injury. In order to treat the injured ankle, all appropriate treatment options should be discussed and followed through by the individual and their doctor. By doing so, a proper treatment plan will be tailored to what is needed for the person to get back to playing sports and their normal life.