ANKLE SPRAIN

An injury to one or more of the ligaments that support the ankle is known as ankle sprain. The ankle ligaments are bands of tissue that runs on the inner and outer sides of the ankle and connect the leg bone to the ankle bone to bind the ankle joint together. These ligaments provide stability to the ankle joint by limiting side-to-side movement.

Ankle sprains may vary in severity. The severity depends on whether these ligaments are stretched, partially torn or completely torn, as well as on the number of ligaments involved.

 

Causes

Ankle sprain can result from a fall, a sudden twist or a traumatic accident that forces the ankle joint out of its normal position. Ankle sprains are commonly associated with sports, or walking or running on an uneven surface.
In some cases, ankle sprain may occur due to congenitally weak ligaments. A history of previous ankle or foot injuries can also weaken the ligaments of the ankle and lead to sprains.

 

Symptoms

Ankle sprain may associate with the following symptoms:

  • Pain

  • Swelling

  • Bruising

  • Walking difficulty

  • Ankle joint stiffness

 

An ankle sprain can be mistaken as an ankle fracture. However, the mechanism of injury of ankle fracture is quite different from ankle sprain, but they may occur simultaneously. Therefor, an accurate diagnosis is required to determine the treatment plan.

 

The Importance of Early Diagnosis and Treatment of Ankle Sprain

There are several reasons why an ankle sprain should be evaluated and treated early:

  • An untreated ankle sprain may lead to chronic ankle instability. Chronic ankle instability is a  condition marked by discomfort, unstable and eventually failure of the ankle joint with arthritis.

  • A bone fracture may be present along with the sprain that, if left untreated, could lead to ankle joint complications.

  • An ankle sprain may be associated with a foot injury that causes discomfort.

  • Rehabilitation of a sprained ankle is required to start directly after injury. If rehabilitation is delayed, the injured ligaments are less likely to heal properly. 

 

Diagnosis

To evaluate an ankle sprain,  a thorough history of the symptoms along with foot and ankle examination is obtained. X-rays are ordered to determine the severity of the injury.

 

Conservative Treatment

Prompt rehabilitation of ankle sprain is crucial. One or more of the following treatment options is recommended:

  • Rest. Stay off the injured ankle or immobilization of the ankle joint in a special walking boot to prevent further injury.

  • Ice. Application of ice pack to the injured area will decrease internal hemorrhage through vasoconstriction and therefor, reduce swelling.

  • Compression. A compressive wrap may be required to control swelling.

  • Elevation. The injured limb should be elevated slightly above the heart level by placing pillows under the foot in order to reduce swelling with gravity.

  • Early physical therapy. As the swelling and pain resolves, physical therapy should be  started as soon as possible to restore the ankle joint range of motion. 

  • Medications. Non-steroidal anti-inflammatory drugs (NSAIDs), or steroidal anti-inflammatory medication may be recommended to reduce pain and inflammation. In few cases, pain medications are needed to provide adequate pain relief.

 

Surgical Treatment

Surgical treatment is considered in severe cases of ankle sprain with completely torn ligaments and ankle instability. Surgical intervention involves repairing the damaged ligaments. After surgery, rehabilitation of the operative side with no weight, ice, compression and elevation are extremely important for successful surgical outcome. Physical therapy is crucial to start after healing to restore the ankle range of motion.

 

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