Ankle Sprain

Ankle Sprains are the most common injuries in organized sport.The most commonly affected is the lateral ankle ligaments and less commonly the medial ankle ligament. Adult females are more commonly affected than adult males. 

Cause

Ankle sprains are due to stretching of the ankle ligaments.

Symptoms

Depending on the severity of the injury and the acuity of the injury there may be limping. Other symptoms may include swelling, bruising, and feelings of instability and tenderness around the lateral or medial ankle 

Diagnosis

The diagnosis of ankle sprains is made based on the history and physical exam. X-rays or MRIs may be beneficial to see if any associated injuries or to rule out fractures. 

Ankle Sprains can be classified as 

-Lateral ankle sprains are the most common and due to ankle inversion with a plantarflexed foot, this leads to injury to the lateral ankle ligaments  - Medial ankle sprains are due to eversion injuries or it may be part of a bigger injury. This leads to injury of the deltoid ligament complex. This complex is strong and is not as commonly injured. 

-Syndesmotic injuries, also known as high ankle sprains may occur from eversion injuries or dorsiflexion and external rotation   These ligaments are a very important aspect of maintaining ankle stability.

Treatment

All ankle ligaments are treated the same initially. The goal is to limit pain and swelling while maintaining motion. 

Initial treatment in the first 2-3 days may involve rest, ice, compression, elevation to prevent swelling and possible splint or brace depending on the severity. 

Pain relievers may be appropriate for pain control.

Physical therapy is the mainstay of treatment for an ankle sprain. This is to improve balance, mobility and strength.

Depending on the symptoms and activity level a brace may be beneficial. 

Most people recover fully without needing surgery. A small minority of people do develop chronic ankle instability. Surgery may be an option for high ankle sprains, chronic ankle instability or if it is a severe ankle sprain with associated injuries. 

Prevention

Lace-up supports can help prevent ankle reinjury during certain sports and activities. Physical therapy may help reduce the risk of reinjury.