Ankle Sprain – Causes, Symptoms and Treatment
An ankle sprain occurs when the ligaments of the ankle joint are overstretched or torn. It is one of the most common sports injuries, causing pain, swelling, and limited range of motion.
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An ankle sprain occurs when the ligaments of the ankle joint are overstretched or torn. It is one of the most common sports injuries, causing pain, swelling, and limited range of motion.
What Is an Ankle Sprain?
An ankle sprain is an injury to the ligaments that support and stabilize the ankle joint. It occurs when the ankle is forced beyond its normal range of motion, causing the ligaments to stretch excessively or tear, without a fracture of the underlying bones. Depending on the severity, the ligaments may be mildly overstretched, partially torn, or completely ruptured.
Causes
Ankle sprains commonly result from sudden, uncontrolled movements of the foot. Typical causes include:
- Rolling or twisting the ankle during sports or on uneven surfaces
- Missteps on stairs or while running
- Contact during team sports such as football or basketball
- Inadequate footwear or pre-existing joint instability
- Previous ankle injuries that have weakened the ligaments
Grades of Severity
Ankle sprains are classified into three grades:
- Grade I: Mild overstretching of the ligaments with no tearing, minor swelling and pain
- Grade II: Partial tear of one or more ligaments, moderate swelling, pain, and slight instability
- Grade III: Complete rupture of the ligament(s), severe swelling, significant pain, and joint instability
Symptoms
Common signs and symptoms of an ankle sprain include:
- Sudden, sharp pain in the ankle joint
- Swelling and bruising (hematoma) around the joint
- Tenderness when pressing on the affected ligaments
- Reduced range of motion in the ankle
- A feeling of instability or giving way when standing or walking
Diagnosis
Diagnosis is typically made through a physical examination, during which a doctor assesses joint stability, palpates the ankle, and reviews the mechanism of injury. X-rays may be ordered to rule out fractures. For a more detailed assessment of ligament integrity, magnetic resonance imaging (MRI) may be used.
The Ottawa Ankle Rules are a widely used clinical decision tool that helps determine when imaging is necessary in emergency settings.
Treatment
Immediate First Aid
Immediately after the injury, the RICE protocol is recommended:
- Rest – avoid putting weight on the ankle
- Ice – apply a cold pack to reduce swelling (never directly on skin)
- Compression – use an elastic bandage to limit swelling
- Elevation – raise the leg to promote fluid drainage
Further Treatment Options
- Immobilization: Elastic bandages or orthopedic braces (orthoses) for mild to moderate sprains
- Pain management: Anti-inflammatory and analgesic medications such as ibuprofen or diclofenac
- Physiotherapy: Targeted exercises to strengthen surrounding muscles and improve proprioception (balance and joint awareness)
- Surgery: In cases of complete ligament rupture with persistent instability, surgical reconstruction may be required
Recovery and Prognosis
Recovery time depends on the severity of the sprain. Mild sprains typically heal within 1 to 2 weeks, while more severe injuries may require several weeks to months of rehabilitation before full activity can be resumed. Without proper treatment and rehabilitation, there is a significant risk of developing chronic ankle instability, which increases susceptibility to repeated sprains.
Prevention
- Always warm up and stretch before physical activity
- Wear supportive footwear or ankle braces during sports
- Perform proprioceptive training (e.g., balance board exercises) to strengthen the stabilizing muscles
- Gradually increase training intensity after an injury
References
- Doherty C. et al. - The Incidence and Prevalence of Ankle Sprain Injury: A Systematic Review and Meta-Analysis of Prospective Epidemiological Studies. Sports Medicine, 2014.
- Kerkhoffs GM. et al. - Diagnosis, treatment and prevention of ankle sprains: update of an evidence-based clinical guideline. British Journal of Sports Medicine, 2012.
- World Health Organization (WHO): Global Report on Falls Prevention in Older Age. Geneva, 2007.
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Related search terms: Ankle Sprain + Ankle Sprain Injury + Sprained Ankle