It results in stretching and tearing of the ligaments on the outside of the ankle. In an eversion injury, the ankle rolls inward and the foot turns outward, damaging the ligaments at the inside of the ankle. In a "high" ankle sprain, a less common type of injury, ligaments that join the two lower leg bones together above the ankle, called the syndesmosis, are injured.
This usually happens if the foot is forced up, or if the leg is forcefully twisted while the foot is planted. This injury can occur either by itself or with an inversion or eversion sprain. If the ligaments of the syndesmosis are injured, the sprain is more severe and takes longer to heal. Damage to the ligament varies from simply stretched or slightly torn to completely torn. Your doctor will grade your sprain accordingly.
People usually feel immediate pain at the site of an ankle sprain. Often the ankle starts to swell immediately and may develop bruising. The affected area is usually tender to touch and may feel "wobbly" or unstable.
In a mild sprain, swelling usually goes down within a few days. The severity of your symptoms usually depends on how much tearing has occurred. In more severe sprains, you are often not able to walk or even put weight on your foot, and your ankle may feel unstable. You usually have extreme pain at first, but some people start to feel better fairly soon. If a sprain does not heal correctly, your ankle joint may be more likely to be injured again or the pain may not go away.
This often occurs with even a slight trauma, such as stepping off a curb or walking on uneven pavement. Some people complain of persistent pain and swelling. Call your doctor now or seek immediate medical care if:. Watch closely for changes in your health, and be sure to contact your doctor if you are not getting better after 1 week.
If your pain is mild and you are able to put some weight on your foot, you may follow the recommendations in the Treatment Overview and Home Treatment sections of this topic. Early treatment followed by rehabilitation exercises help your ankle heal properly. If treatment recommendations are not followed, your ankle may stay weak and unstable.
Your family doctor , general practitioner , a nurse practitioner , or an emergency medicine doctor can evaluate, diagnose, and treat ankle sprain.
You may be referred to a specialist, such as:. Your doctor will ask you when and how the ankle sprain occurred and ask about any prior injuries. Next, your doctor will examine your foot, ankle, and lower leg and even your knee to see if any other injury occurred.
He or she may ask you to move your foot up and down and to take a few steps if possible. Your doctor will then carefully try moving your foot and ankle to see if the ligaments are intact and what movements cause pain.
If your sprain is mild, an X-ray may not be taken. If your sprain is more severe, you may need X-rays to evaluate the ankle. X-rays can help your doctor find out whether you have any ligament tears, broken bones, or bones that have moved out of their normal positions. X-rays are often taken for children because of potential injury to the bone's growth plate and possible disruption of normal growth. Doctors may take X-rays of both ankles so they can compare the injured ankle with the one that is healthy.
Initial treatment for an ankle sprain is summarized as the RICE approach:. Be safe with medicines. Read and follow all instructions on the label. It may help to wear hiking boots or other high-top, lace-up shoes for support. Your doctor may suggest that you keep some or all of your weight off your ankle as it heals.
If this happens, learn to use your crutches or walker properly and safely. Almost all ankle sprains heal on their own with proper home treatment and rehabilitation rehab exercises. Surgery to repair torn ligaments is usually only considered when there is a severe ligament tear or tears or if the ankle remains unstable after rehab. Surgery is also a consideration if you have broken a bone. Ankle sprains take an average of 6 weeks to heal but can take can up to 4 months, depending on the severity.
An ankle brace, air stirrup, hiking boots, or other form of ankle support should be worn during this time to protect the ligaments. After the ankle is healed, wearing an ankle brace or taping the ankle may help prevent re-injury. For more painful and severe sprains, you may not be able to walk, although you might be able to bear some weight while using crutches and a protective brace, such as a brace with a built-in air cushion or other form of ankle support.
If pain is severe, use crutches until your doctor tells you that you can begin to bear weight. In general, if your pain is bearable, you should try to walk or bear some weight while using crutches and a protective brace, because these activities promote healing.
Some people who have repeated or severe sprains can develop long-term joint pain and weakness. Rehabilitation rehab exercises for an ankle sprain can be done at home to promote proper healing and prevent chronic pain and instability. When rehab exercises are not followed after a sprain, the ankle can become weak and unstable.
In the case of a minor sprain, rehab exercises begin soon after the injury with walking. You can try wearing hiking boots or other high-top, lace-up shoes for support. Stretching exercises should be continued daily and especially before and after physical activities to prevent re-injury. Even after your ankle feels better, continue with muscle-strengthening exercises and balance and control exercises several times a week to keep your ankles strong.
The timing and type of rehab exercises may vary according to your doctor's or physiotherapist's preferences. You will probably do the following types of exercise. Blahd Jr. Author: Healthwise Staff. Improved proprioception and muscle strengthening can be very successful in managing these patients, and current data do not support using surgical treatments unless a full course of physical therapy has failed to bring the patient back to full strength and mobility.
Patients with recurrent sprains can benefit significantly from a guided therapy program focusing on strengthening the peroneal muscles the muscles on the outside of the calf , which can improve dynamic ankle stability. Patients usually reach a maximum benefit at 6 to12 weeks.
Any patient who exhibits recurrent sprains, ankle rolling or other instability after that time or has associated injuries such as swelling, locking or catching may be a candidate for surgery. These patients should be evaluated by an orthopedist to discuss optimal management to decrease the risk for future ankle problems such as arthritis.
Ankle Sprain Types and Treatments. These studies show that this can be due to a number of problems, including: Torn or dislocated tendons Underlying cartilage damage Recurring chronic ankle sprains It is not clear how many cases of chronic ankle sprain result from a single, initial ankle sprain. Anatomic Classifications Grade I ankle sprain — lateral ligaments are strained overstretched Grade II ankle sprain — partial tearing of one or several of these ligaments Grade III ankle sprain — complete rupture tear one or more of the lateral ligaments Functional Classifications Grade I injury — the patient is able to fully weight bear and walk Grade II injury — the patient walks with a noticeable limp Grade III — the patient is unable to walk These grading systems can also predict timelines for recovery, which range from 1 to 2 weeks Grade I to 6 to 8 weeks Grade III.
Treatments It is very important to reduce swelling in the immediate post-injury period. This includes: The RICE protocol Rest, Ice, Compression and Elevation Early range of motion exercises progressive weightbearing guided by level of pain Physical therapy, which includes proprioceptive training balance exercises , is also beneficial for some patients.
Several studies have shown that patients may develop proprioceptive deficits. This means that the body loses some of its ability to localize the position of the ankle in space and fire the ankle muscles accordingly.
What this means is that the muscles that protect the ankle from rolling over may not protect patients as well when they are walking on uneven ground.
When most ankle sprains happen, the ankle is flexed and inverted the foot turned inward toward the opposite foot. With rest and proper treatment, most ankle sprains heal within 4—6 weeks. But some can take longer. Most ankle sprains happen when the ankle twists, or when the foot rolls onto its side. Most happen during athletic activities. But you don't have to be playing sports to injure an ankle — sprains can happen from taking an awkward step or tripping on the stairs.
To diagnose ankle sprains, doctors ask about the injury and do an exam. They'll check the bones and soft tissue of the ankle, watch the person's range of motion, and do strength tests. Sometimes, the doctor may order an X-ray or other imaging study to see if there are other injuries, such as a broken bone.
Doctors may treat a more serious ankle sprain with a splint or temporary cast. Very rarely, a person might need surgery. If you have an ankle sprain, you'll probably need to take some time off from sports and other strenuous physical activities. Make sure your sprained ankle is completely healed first. Not overdoing things is key when it comes to sprains.
So follow your doctor's advice and don't push yourself or feel pressure to get back into sports or other activities too soon.
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