A sprained ankle occurs during sudden sideways or twisting movement of the foot. An awkward step or an uneven surface instigate an ankle sprain, which explains why sprained ankles are common orthopedic injuries. It is the most common foot and ankle injury.
An ankle sprain is a ligament injury to the ankle. The ligaments are structures that control excessive movement of the joint. When an ankle sprain happens, the ligament is over-stretched and is either partially or completely torn.
There are two vast categories of ankle sprain
- Inversion ankle sprains
The most common type of ankle sprain manifests when the foot is inverted, falling inward. This type of ankle sprain is outer, or lateral, ligaments are over-stretched. There are three ligaments that attach to the outer side of the ankle. About 90% of ankle sprains are inversion injuries. Pain is always on the outside of the ankle, and there is usually no pain on the inside.
- Eversion ankle sprains
The other type of sprained ankle is an eversion injury, where the foot twists outwards. The inner ligament called the deltoid ligament, is over-stretched. Patients feel no pain on the inner side of the ankle.
Symptoms of an ankle sprain
- Grade I Ankle Sprain:
Grade I ankle sprains cause stretch the ligament. The symptoms generally is binary, pain and swelling. Most patients can walk without crutches, but may not jog or jump.
- Grade II Ankle Sprain:
A grade II ankle sprain is more severe, partial tearing of the ligament. There is more significant swelling and bruising, because of bleeding under the skin. Patients usually have pain when walking but can take a few steps.
- Grade III Ankle Sprain:
Grade III ankle sprains are complete ligaments tears. The ankle is usually quite painful and walking may be difficult. Patients may feel instability, or a buckling response in the ankle joint.
Pain and swelling are the most common symptoms of an ankle sprain. Bruising is noticeable over the area of injury and amplifies downward to the toes days after the ankle sprain. Because the gravity is directing blood downwards in the foot.
Significant ankle sprain symptoms that need immediate medical attention are
- inability to walk on the ankle
- significant swelling
- symptoms that do not improve quickly or persist beyond a few days
- pain in the foot or above the ankle
Characterizing between a sprained ankle and an ankle fracture is complex, which is why an x-ray is needed. While moderate pain and swelling are common symptoms following a simple sprained ankle, symptoms like inability to place weight on the leg, numbness of the toes, or pain that is difficult to manage is worrisome.
Distinguishing a ‘high ankle sprain’
A high ankle sprain is a particular ligament injury around the ankle. The ligaments above the joint are also injured. These ligaments, are the syndesmosis ligaments, can also be injured and may necessitate a longer duration of rehabilitation.
How to recuperate from an ankle sprain
Range-of-motion (ROM) exercises can maintain ankle motion, and stretch the injured ligaments in the ankle joint. Like
- Achilles stretches
- alphabet writing
Strength exercises for ankle sprains is refortifying the muscles surrounding the ankle joint. By strengthening these muscles, it can help support the ankle joint, and help prevent re-aggravation. Some exercises to perform after an ankle sprain are
- toe raises
- heel and toe walking
- Proprioceptive training
Proprioception is the ability of the body to respond to the brain. After an ankle sprain, the proprioception of the joint can be damaged, furthering problems controlling ankle movements.
- Activity-specific training
Activity specific exercises is walking or jogging, or can be more intense for athletes that play basketball, soccer, or other sports. What is important is to slow progression. Begin at very low intensity, and very low duration of activity, then slowly aggrandize, never suddenly increase either the intensity or duration of your activity.
Here is a sample progression exercises for a high-intensity player
- jogging
- figure of eights
- box runs
How about if the pain persists?
The most common cause of persistent pain following an ankle sprain is incomplete rehabilitation. Which means a patient either didn’t complete the right type of rehabilitation, or they did not progress appropriately (too fast or too slow). Ensure advice with a doctor, work with a physical therapist.
