Ligaments can be damaged due to:
Overstretching, as occurs when the foot is twisted inwards or outwards during running, jumping, walking on an uneven surface, or due to wearing inappropriate shoes.
Trauma from a direct blow or a fall
Factors increasing the risk of acquiring ankle sprains:
- Previous ankle sprain (the chances of acquiring another sprain doubles).
- Excessive running or jumping (participation in certain sports)
- People born with weak ankles
- Excessive body weight
- Weak muscles
- Pain and swelling are the most common symptoms of an ankle sprain. The severity of pain depends upon the extent of the damage. In a grade I ankle sprain, there is mild pain and swelling, while in grade III there is severe pain and swelling.
- Bruising and tenderness of the area
- Pain on placing weight at the affected joint
- Stiffness of the joint
- Inability to walk
Proper evaluation and treatment is a must, even when there is no significant swelling or pain.
History of the patient regarding how the injury occurred, along with a careful physical examination of the joint help to diagnose a sprain.
An X-ray is usually required to examine the extent of the injury and rule out any fractures in the area.
Treatment depends upon the severity of the sprain and involves controlling pain and swelling, and immobilizing the joint to allow for healing.
-Following the RICE protocol immediately after the injury (in the first 48 hours), not only helps to ease the pain but also reduces the swelling. It includes:
Rest: keeping the weight or any kind of stress off the joint
Ice application: for about 15 -20 minutes, several times a day, in the first 2 or 3 days
Compression: applying pressure through an elastic bandage (the bandage should not be too tight)
Elevation: elevating the injured joint above the heart level helps to reduce swelling.
Other measures that may help include:
Use of anti-inflammatory painkillers such as ibuprofen, acetaminophen, etc.
An ankle-brace or cast can be applied to limit movement at the joint. The casts or splints are usually applied for two to six weeks.
Crutches are also advised to help keep the weight off the affected joint
Manual and ultrasonic massage therapy also help shorten the recovery period by reducing the stiffness and improving the range of motion at the joint.
Proper rehabilitation is important in order to restore normal function of the joint. The ligaments often become loose or weaken after the injury, leading to instability at the joint and making the foot more prone to twisting or rolling. A joint that has suffered a sprain is doubly at risk of getting another sprain in the future.
Surgical treatment is not often required for an ankle sprain and usually involves repairing the torn ligaments. The surgical procedure depends upon several factors such as the extent of damage to the ligaments and the activity level of the individual. After the surgical repair, a cast needs to be applied for about six weeks to allow for complete healing.
Exercises to strengthen the muscles around the ankle help to improve joint stability.
Additional ankle supports, such as strapping or ankle braces, may also be recommended for use on uneven ground or during sports activities.