Ankle Injuries

What is an Ankle Sprain?

An ankle sprain is an injury to one or more ligaments in the ankle, usually on the outside of the ankle. Ligaments are bands of tissue, like rubber bands, that connect one bone to another and hold the joints together. In the ankle joint, ligaments provide stability by limiting side-to-side movement, but allowing motion in the proper directions.

Some ankle sprains are much worse than others. The severity of an ankle sprain depends on whether the ligament is stretched, partially torn, or completely torn, as well as on the number of ligaments involved. Ankle sprains are not the same as strains, which affect muscles rather than ligaments.

What Causes a Sprained Ankle?

ankle sprain

Sprained ankles often result from a fall, a sudden twist, or a blow that forces the ankle joint out of its normal position. Ankle sprains often occur while participating in sports, wearing inappropriate shoes, or walking or running on an uneven surface.

Sometimes ankle sprains occur because of congenitally weak ankles. Previous ankle or foot injuries can also weaken the ankle and lead to sprains.

Signs and Symptoms

The signs and symptoms of ankle sprains may include, pain or soreness, swelling, bruising, difficulty walking, and stiffness in the joint.

These symptoms may vary in intensity, depending on the severity of the sprain. Sometimes pain and swelling are absent in people with previous ankle sprains. Instead, they may simply feel the ankle is wobbly and unsteady when they walk. Even if you don't have pain or swelling with a sprained ankle, treatment is crucial. Any ankle sprain, whether it's your first or your fifth, requires prompt medical attention.

If you think you've sprained your ankle, immediately begin using the "R.I.C.E." method: Rest, Ice, Compression, and Elevation to help reduce swelling, pain, and further injury.

Why Prompt Medical Attention is Needed

There are four key reasons why an ankle sprain should be promptly evaluated and treated:

  1. An untreated ankle sprain may lead to chronic ankle instability, a condition marked by persistent discomfort and a "giving way" of the ankle. You may also develop weakness in the leg.
  2. You may have suffered a more severe ankle injury along with the sprain. This might include a serious bone fracture that could lead to troubling complications if it goes untreated.
  3. An ankle sprain may be accompanied by a foot injury that causes discomfort but has gone unnoticed thus far.
  4. Rehabilitation of a sprained ankle needs to begin right away. If rehabilitation is delayed, the injury may be less likely to heal properly.

Non-Surgical Treatment and Rehabilitation

When you have an ankle sprain, rehabilitation is crucial. The following are treatment options:

  • Immobilization. Depending on the severity of your injury, you may require a short-leg cast, a walking boot, or a brace to keep your ankle from moving. You may also need crutches.
  • Early Physical Therapy. You may require a rehabilitation program as soon as possible to promote healing and increase your range of motion. This includes doing prescribed exercises.
  • Medications. Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be recommended to reduce pain and inflammation. In some cases, prescription pain medications are needed.
  • Icing. You may be advised to ice your injury several times a day until the pain and swelling resolves. Place a Zip-Lock bag full of ice cubes, wrapped in a thin towel against the injured area.
  • Compression Wraps. To prevent further swelling, you may need to keep your ankle wrapped in an elastic bandage or stocking.

When is Surgery Needed?

In more severe cases, surgery may be required to adequately treat an ankle sprain. Surgery often involves repairing the damaged ligaments.

After surgery, rehabilitation is extremely important. Completing your rehabilitation program is crucial to a successful outcome.

What is Chronic Ankle Instability?

chronic ankle instability

Chronic ankle instability is a condition characterized by a recurring "giving way" of the outer or lateral side of the ankle. This condition often develops after repeated ankle sprains. Usually the "giving way" occurs while walking or doing other activities, but it can also happen just standing. People with chronic ankle instability often complain of:

  • A repeated turning of the ankle, especially on uneven surfaces or when participating in sports
  • Persistent discomfort and swelling
  • Pain or tenderness

What Causes It?

Chronic ankle instability usually develops following an ankle sprain that has not adequately healed or was not rehabilitated completely. When you sprain your ankle, the connective ligaments are stretched or torn. The ability to balance is often affected. Proper rehabilitation is needed to strengthen the muscles around the ankle.

Repeated ankle sprains often cause and perpetuate chronic ankle instability. Having an ankle that gives way increases your chances of spraining your ankle repeatedly. Each subsequent sprain leads to further weakening and stretching of the ligaments resulting in greater instability and the likelihood of developing additional problems in the ankle.

Evaluation and Diagnosis

ankle instability

If your ankle feels wobbly or unstable and gives way repeatedly, or if you've had recurring ankle sprains,  have your condition evaluated and treated. Chronic ankle instability that is left untreated leads to continued instability, activity limitations, arthritis, and tendon problems.

Treatment Options

Treatment for chronic ankle instability is based on the results of the examination and tests, as well as on the patient's level of activity.

Non-surgical treatment may include:

  • Physical therapy. Physical therapy involves various treatments and exercises to strengthen the ankle, improve balance and range of motion, and retrain your muscles. As you progress through rehabilitation, you may also receive training that relates specifically to your activities or sport.
  • Bracing. Some patients wear an ankle brace to gain support for the ankle and keep the ankle from turning. Bracing also helps prevent additional ankle sprains.
  • Medications. Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be prescribed to reduce pain and inflammation.

In some cases, surgery based on the degree of instability or lack of response to non-surgical approaches. Surgical options mainly involve repair or reconstruction of the damaged ligaments. However, other soft tissue or bone procedures may be necessary depending on the severity of your condition and whether you have other conditions in the foot or ankle. The length of the recovery period will vary, depending on the procedure or procedures performed.

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All information on this site © 2011 Joshua Kaye, DPM.

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