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Ankle Sprain

Ankle sprains occur most often when the ankle inverts unexpectedly, causing the ligaments that support the ankle to stretch past their limits and tear.  While most sprains are minor injuries, some ankle sprains result in severe swelling and can require immobilization.  This common injury happens to people of all ages and can range from mild to severe depending on the damage done to the ligaments.  Without the proper rehabilitation and treatment, a severe sprain can cause your ankle to weaken, increasing the chances of a recurrence.  Repeated sprains can cause long-term problems, such as instability, arthritis or chronic pain.

Diagnosing Ankle Sprain

Podiatrists will diagnose an ankle sprain through a physical examination of the foot, which will help to determine the grade of the injury.  Gently pressing around the ankle to determine the injured ligaments, and then moving the ankle in different directions to check the range of motion will help the doctor diagnose the ankle sprain.  If no bone is broken, the doctor can most likely determine the grade of the sprain based on the swelling, bruising, and pain level.  To rule out any broken bones in the foot, the doctor might order x-rays.  Stress x-rays may be taken while moving the foot and ankle in different directions so the doctor can determine the severity.  If a severe ligament injury is suspected, magnetic resonance imaging (MRI) might be ordered to check the ligament damage, cartilage damage, or damage to the bone or joint surfaces.  An ultrasound might be ordered to observe the ligament as your ankle is being moved, so the stability provided by the ligament can be assessed.  The podiatrist will then have an idea of the grade of the sprain.  Grade 1 consisting of stretching or slight tearing of the ligament, Stage 2 consisting of significant but incomplete tear and Grade 3 which includes a completely torn ligament.

Treating Ankle Sprain

Ankle sprains are most commonly treated without surgical intervention.  Ankle sprain treatment consist of three phases for all sprains. Those phases include:

  • Phase 1: Resting, protecting the ankle and reducing swelling
  • Phase 2: Restoring the range of motion, flexibility, and strength
  • Phase 3: Maintenance exercises and gradually increasing activity

For minor sprains, recovery may take two weeks a podiatrist will likely recommend home treatment using the RICE protocol, which includes Rest, Ice, Compression, and Elevation.  Non-steroidal anti-inflammatory drugs (NSAIDS), such as naproxen or ibuprofen might help with swelling and pain.  Higher grade sprains could take 8 weeks to fully heal and may require the use of crutches with a cast or cast-boot.  In the early phases of recovery, an air stirrup-type brace may be fitted to provide extra support during the early phases of recovery.

A grade 3 sprain may require a short leg cast or cast-brace for up to 12 weeks and in some cases may require surgery to repair a completely torn ligament.

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