An ankle sprain, usually the result of a fall or injury that "twists" the ankle the wrong way, is a common injury that can affect the soft tissues, typically the ligaments, of the ankle. Ankle sprains are the number one injury concerning the ankle joint.
An ankle sprain, or lateral ankle sprain, can often force sufferers to refrain from physical activity for four to eight weeks, depending on the severity of the damage done. The reason: An ankle sprain results in a stretching to a partial or complete tear of the ankle ligaments on the outside of the foot.
Causes:
Acute trauma or injury usually results in an acute ankle sprain, or outward twisting of the ankle. The following conditions may predispose individuals to an ankle sprain:
- A high arch or supinated foot type. Supinated feet turn inward (pigeon-toed).
- A neuromuscular disorder that may cause the afflicted person to invert the ankle involuntarily
- A muscle imbalance resulting in weak peroneal muscles, the muscles of the ankle joint.
- Ligamentous laxity, or "looseness of the ligaments," a condition characterized by the softening of the ligaments holding the bones together.
- Limb length discrepancy.
- Previous minor ankle sprains, which can weaken the ankle muscles.
People who over supinate, or roll to the outside of their ankles, also tend to get repeated ankle sprains. Their actions weaken the ankle, perpetuating the occurrence of continued sprains.
Symptoms:
Ankle sprains are classified by severity:
- Grade 1: mild or minimal sprain with no tearing.
- Grade 2: Moderate sprain with incomplete or partial tear of the ligaments with marked swelling, eccymosis (black and blueness), pain and difficulty walking.
- Grade 3: A complete tear or rupture of the ligaments with swelling, internal bleeding, ankle instability and inability to walk.
Improper initial treatment of an acute ankle sprain often leads to poor healing and chronic lateral ankle instability, where the ankle constantly "gives way" on irregular terrain and even on flat surfaces.
Relief and Prevention:
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Treatment for ankle sprains is based on the severity of injury.
The RICE system – rest, ice, compression, elevation – can be used to treat Grade I sprains:
- Rest the painful part and refrain from activity.
- Apply intermittent ice to the area.
- Apply a compressive wrap.
- Elevate the extremity.
Over-the-counter oral anti-inflammatory medications should alleviate the pain.
Following healing, consider the following:
- Continue to wrap or tape the ankle, or apply an ankle support for all activity.
- Stretch thoroughly before and after athletic activity.
- Strengthen the peroneal muscles.
- Use lateral heel wedges to prevent the ankle from rolling out.
- Wear good, supportive shoes, and consider high-topped shoes for athletic activities. Remember, an ideal support shoe has the following characteristics:
- A firm heel counter
- A wide enough toe box to accommodate toes without pinching
- A semi-rigid or rigid shank
- A removable inner sole
- A long vamp
- A heel measuring between ¾ - 1½ inches
Treatment of Grade 2 and 3 ankle sprains should be reserved for a podiatrist or other trained health care personnel. Severe injury requires x-rays to evaluate the possibility of bony involvement as well.
Information on foot, leg and lower body health conditions provided by The Podiatry Institute, dedicated to advancing the standard of care in podiatric medicine and its effects on muscoskeletal health.