What is an ankle sprain?
An ankle sprain occurs when ligaments (cord like bands of connective tissue that attach bones together) around the ankle are torn or over stretched. The lateral ankle is affected in 85% of cases and damage occurs when the ankle rolls outward and the foot moves inward (forced inversion). Combine this with high force and the ligaments get pushed beyond their zone of tolerance. The medial ankle is affected with forced eversion (movement outwards away from the body) and is less common.
How does it present?
An ankle sprain will occur after a trauma i.e. a fall, twist or sudden knock to the ankle. Pain, swelling and restricted movement will develop but the extent of this will depend on the extent of damage imposed. Ankle sprains tend to be graded according to their severity:
- Grade 1:
The least damage occurs with a grade 1 sprain, which affects 1 or 2 ligaments. There can be minor swelling and pain, and sometimes a small amount of bruising and stiffness in the ankle. You will be able to weight bear (ie, put your full standing weight on the injured ankle).
- Grade 2:
Significant swelling and bruising develops. Weight bearing can often seem difficult to begin with but is possible. You are likely to walk with a limp. The ankle often feels unstable and vulnerable and depending on your daily activities and recovery goals, you may need an Aircast boot to ensure optimal ligament healing in the early stages.
- Grade 3:
This often involves a complete rupture of 1 or 2 ligaments and is often affiliated with bone bruising or fractures in more severe cases. Cartilage damage can also occur when significant force has been involved in the trauma. Imaging (ie. an x-ray) will be essential to confirm the extent of the damage and whether surgical intervention is required.
How is it treated?
A comprehensive rehabilitation programme is important to ensure that the damaged tissue heals to its fullest. This will involve progressive strength and balance work, a gradual introduction to impact and then change of direction drills and sport specific training. Failure to follow a full programme of treatment can result in frequent repeat injuries.
What You Need To Know
- Recurrent ankle sprains are common as patients often fail to complete the full treatment programme.
- If you struggle to weight bear on the effected side or if swelling develops you should get a professional opinion on the injury.
- A grade 1 ankle sprain will take 4-6 weeks for optimal recovery.
- Braces and supports are only advisable in the early stages post injury and for chronic ankle instability and pain.