Ankle sprain

Overview

A sprained ankle is an injury that occurs when you roll, twist, or turn your ankle in an awkward way. This can stretch or tear the tough bands of tissue (ligaments) that help hold your ankle bones together. Ligaments help stabilize joints, preventing excessive movement. A sprained ankle occurs when the ligaments are forced beyond their normal range of motion. Most sprained ankles involve injuries to the ligaments on the outer side of the ankle. Causes of a sprained ankle might include:

  • A fall that causes your ankle to twist
  • Landing awkwardly on your foot after jumping or pivoting
  • Walking or exercising on an uneven surface
  • Another person stepping or landing on your foot during a sports activity

Signs and symptoms of a sprained ankle vary depending on the severity of the injury. They may include:

  • Pain, especially when you bear weight on the affected foot
  • Tenderness when you touch the ankle
  • Swelling
  • Bruising
  • Restricted range of motion
  • Instability in the ankle
  • Popping sensation or sound at the time of injury

Treatment for a sprained ankle depends on the severity of your injury. The treatment goals are to reduce pain and swelling, promote healing of the ligament, and restore function of the ankle.

For self-care of an ankle sprain, use the R.I.C.E. approach for the first two or three days:

  • Rest. Avoid activities that cause pain, swelling, or discomfort.
  • Ice. Use an ice pack or ice slush bath immediately for 15 to 20 minutes and repeat every two to three hours while you’re awake. If you have vascular disease, diabetes, or decreased sensation, talk with your doctor before applying ice.
  • Compression. To help stop swelling, compress the ankle with an elastic bandage until the swelling stops. Don’t hinder circulation by wrapping too tightly. Begin wrapping at the end farthest from your heart.
  • Elevation. To reduce swelling, elevate your ankle above the level of your heart, especially at night. Gravity helps reduce swelling by draining excess fluid.

Because walking with a sprained ankle might be painful, you may need to use crutches until the pain subsides. Depending on the severity of the sprain, your doctor may recommend an elastic bandage, sports tape, or an ankle support brace to stabilize the ankle. In the case of a severe sprain, a cast or walking boot may be necessary to immobilize the ankle while the tendon heals.

Once the swelling and pain is lessened enough to resume movement, your doctor will ask you to begin a series of exercises to restore your ankle’s range of motion, strength, flexibility, and stability. Your doctor or a physical therapist will explain the appropriate method and progression of exercises.  Balance and stability training is especially important to retrain the ankle muscles to work together to support the joint and to help prevent recurrent sprains. These exercises may involve various degrees of balance challenge, such as standing on one leg. If you sprained your ankle while exercising or participating in a sport, talk to your doctor about when you can resume your activity. Your doctor or physical therapist may want you to perform particular activity and movement tests to determine how well your ankle functions for the sports you play.

In rare cases, surgery is performed when the injury doesn’t heal or the ankle remains unstable after a long period of physical therapy and rehabilitative exercise. Surgery may be performed to:

  • Repair a ligament that won’t heal
  • Reconstruct a ligament with tissue from a nearby ligament or tendon

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