Ankle sprains are very common. Everybody turns an ankle. A simple twist of the ankle can cause ligaments to stretch or tear, resulting in bruising, swelling, and pain. Ankle sprains range from mild to severe, depending on the amount of damage and the number of ligaments affected.
Causes
Ankle sprains occur for a variety of reasons. Usually, there is a forced or quick shifting movement when you plant your foot. The most common sprain, or inversion injury, happens when the ankle rolls out and the foot turns in causing stretching or tearing of ligaments on the outside of the ankle. An eversion injury happens when the ankle rolls in and the foot turns out affecting the ligaments on the inside of the ankle. A high ankle sprain occurs in either an inversion or an eversion injury when the ligaments above the ankle are injured.
Symptoms
The symptoms of an ankle sprain depend on the severity of the stretch or tear of the ligaments. Common to all sprains are tissue injury and inflammation. Swelling is due to increased fluid in the soft tissue surrounding the joint. Pain and tenderness are the results of nerve sensitivity. Redness, warmth, and bruising are due to the increase in blood flow to the area. Some ankle sprains are accompanied by a popping sound. There may be a lack of stability when attempting to stand and walk or even a total inability to put weight on the foot or walk.
Diagnosis
With a mild sprain, symptoms usually ease within a few days. To accurately determine the extent of the injury it is best to consult with Dr. Burmeister. He will ask questions about how the injury occurred. He will also want to know if there have been any prior injuries. A physical exam will check the foot, ankle, lower leg, and knee to determine if there are any other injuries. If necessary, Dr. Burmeister will order x-rays to check for broken or dislocated bones. When children are injured, x-rays show if there has been damage to the growth plates in the bones supporting the ankle. As part of the diagnosis, Dr. Burmeister will “grade” the injury according to the following:
- Grade I injuries are due to stretching or slight tearing of the ligament. There is mild tenderness, stiffness, and swelling.
- Grade II injuries are due to larger tearing of the ligament. There is moderate pain, bruising, and swelling.
- Grade III injuries are due to complete tearing of the ligament or ligaments. There is severe pain, bruising, and swelling.
Treatment
Treatment for an ankle sprain depends upon its severity. Healing time ranges from six weeks to four months.
- Most sprains heal when properly treated at home. At-home care includes Rest, Ice, Compression, Elevation (RICE) or Protection, Rest, Ice, NSAIDs, Compression, Elevation (PRINCE). In addition, Dr. Burmeister may recommend the use of crutches or a walker while the ankle heals. Rehabilitation exercises at home or with a physical therapist might start within a few days of the injury. Such exercises help to lessen pain, weakness, and instability. They are critical elements necessary for proper healing.
- In some cases, surgery is necessary. When the ligament tear is severe, a bone is broken, or rehabilitation is not successful, Dr. Burmeister will consider surgery as an option.
Prevention
So who wants an ankle sprain? Who wants a second or third ankle sprain? Nobody in their right mind! That’s where prevention comes into play.
- Shoes matter! Choose the right shoes for the activity. Consider heel height and ankle support.
- Working and playing surfaces matter! Tend to holes, obstacles, and uneven areas.
- Ankle strength and flexibility matter! The proper exercises will help keep you upright.
- Pre-exercise and pre-sport training, conditioning, and warm-ups matter! If you’re not in shape to do it, don’t!
- Flat feet and bunions matter! These conditions may cause instability.
- Whether or not you’ve had repeated sprains matters! Weak ankles need the support of taping or of elastic bandages.
If you experience an ankle sprain, Dr. Jeffrey Burmeister, DPM, and his experienced staff are ready to fully diagnose, treat, and see you on your way to pain-free living.
