Sprained Ankle

Injury mechanism of sprained ankle

The ligaments of the ankle hold the joint in position. They protect the ankle joint from excessive movements.

Ankle sprain is the ligaments being stretched beyond its normal range. A severe sprain causes actual tear of the elastic fibers.

Ankle sprain can be classified as inversion and eversion sprain. Inversion sprain and eversion sprain cause pain along the outer side and the inner side of the ankle respectively. Eversion sprain can result in injury to the tendons or to the ligaments that support the arch and should always be evaluated by a doctor.

Ligament injury can also occur above the ankle joint. Ligament between the two bones in the shin (fibula and tibia) is injured. This type of ankle sprain usually takes more time to heal. Patients may still have pain after 6 weeks.

Signs and symptoms of ankle sprain

• Pain and swelling of ankle
• Increased warmth and redness of ankle
• Find it difficult to move the ankle
• Bruising

Severity of ankle sprain

• Grade I injury: Mild stretching of the ligament without joint instability
• Grade II injury: Partial tear of the ligament. Joint instability may be present.
• Grade III injury: Complete rupture of the ligament with instability of the joint

Treatment

Healing usually takes around 6 weeks. Healing time increases with the severity of the sprain.

Grade I sprain

• Rest (R)
  • Walk less or use walking aids if you really need to walk.
• Ice (I)
  • Before the swelling goes down, especially in the first 24 to 72 hours, apply ice packs for 10 to 20 minutes every hour or two during the day. Keep a thin cloth between the ice and your skin, and press the ice pack firmly against all the contours of the affected area.
• Compression (C)
  • Apply an elastic compression wrap to reduce swelling. AVOID over compression, as it can affect blood circulation.
• Elevation (E)
  • Raise your ankle (ideally above your heart level upon lying) as frequent as possible to reduce swelling.

Grade II sprain

• Follow the RICE principle stated above
• Expect more healing time
• Your doctor may prescribe splint to immobilize your ankle

Grade III sprain

• Follow the RICE principle
• Surgery may be needed to restore ankle stability

Exercise

• Exercise is a key component of your rehabilitation
• Goals of exercise are
  • To regain the ankle range of movement
  • To improve the strength of the surrounding muscles
  • To improve balance
• Exercise needed depends on your degree of injury and may vary from patient to patient. Consult your physician or physiotherapist about the exercise.

(All information provided is for reference only. Please contact your physiotherapist or physician should you have any enquiry.)

The above information was produced by Physiotherapy Department, Canossa Hospital (Caritas).

Please call 28255392 for physiotherapy appointment

References

• American orthopedic foot and ankle society
• American Academy of Orthopedic surgeons
• Ankle Stability and Movement Coordination Impairments: Ankle Ligament Sprains (J Orthop Sports Phys Ther. 2013;43(9):A1-A40. doi:10.2519/jospt.2013.0305)