Ankle Sprain – Causes, Symptoms and Treatment
An ankle sprain occurs when the ligaments around the ankle joint are overstretched or torn. It is one of the most common sports injuries, causing pain, swelling, and reduced mobility.
Things worth knowing about "Ankle Sprain"
An ankle sprain occurs when the ligaments around the ankle joint are overstretched or torn. It is one of the most common sports injuries, causing pain, swelling, and reduced mobility.
What Is an Ankle Sprain?
An ankle sprain (medically known as a distortion of the upper ankle joint) is an injury to the ligaments that stabilize the ankle. It occurs when the foot twists or rolls unexpectedly, causing the ligaments to be overstretched or partially torn. Ankle sprains are among the most frequent injuries in both everyday life and sports.
Causes
The most common cause is a sudden inward rolling of the foot, which places excessive stress on the outer ligaments of the ankle. Typical triggers include:
- Sports activities such as football, basketball, or running
- Uneven or slippery surfaces
- Inappropriate or unsupportive footwear
- Muscle fatigue or poor coordination
- Previous ankle injuries
Symptoms
Symptoms typically appear immediately after the injury and vary depending on severity:
- Pain around the ankle, especially when bearing weight or moving
- Swelling and tenderness over the affected ligament
- Bruising (hematoma) caused by ruptured small blood vessels
- Reduced range of motion in the joint
- In severe cases: a feeling of instability or complete loss of function
Severity Grades
Ankle sprains are classified into three grades:
- Grade I: Mild overstretching without a tear, slight swelling, minimal functional impairment
- Grade II: Partial tear of one or more ligaments, noticeable swelling and pain, moderate instability
- Grade III: Complete rupture of a ligament, significant swelling, marked instability, and major functional loss
Diagnosis
Diagnosis begins with a physical examination in which the doctor assesses joint stability and palpates the ligaments. The Ottawa Ankle Rules are used to determine whether an X-ray is needed to rule out a fracture. If a ligament tear is suspected, an ultrasound or MRI (magnetic resonance imaging) may be performed.
Treatment
Immediate First Aid (RICE Protocol)
Immediately after the injury, the RICE protocol is recommended:
- Rest: Stop activity immediately
- Ice: Apply ice to the ankle (never directly on the skin)
- Compression: Apply a compression bandage to reduce swelling
- Elevation: Keep the injured leg elevated to help reduce swelling
Further Treatment Options
Depending on the grade of the sprain, the following treatments may be used:
- Pain relief medication: Anti-inflammatory drugs such as ibuprofen or diclofenac can help reduce pain and swelling.
- Brace or taping: To stabilize the joint and prevent further injury
- Physiotherapy: Exercises to strengthen the surrounding muscles and improve balance and coordination
- Surgery: Rarely required, only in cases of complete ligament rupture with persistent instability
Recovery and Prognosis
Mild sprains (Grade I) typically heal within one to two weeks. Grade II injuries often resolve within four to six weeks. Complete ligament ruptures (Grade III) may require several months of recovery. Consistent rehabilitation is essential to prevent re-injury, as untreated sprains significantly increase the risk of chronic ankle instability.
Prevention
The following measures can help reduce the risk of ankle sprains:
- Wearing appropriate, supportive footwear
- Warming up and stretching before physical activity
- Balance and coordination training
- Using ankle braces or tape when instability is known
References
- Deutsche Gesellschaft für Orthopädie und Unfallchirurgie (DGOU): Guideline on Ankle Distortion, 2017.
- Doherty C, Bleakley C, Delahunt E, Holden S: Treatment and prevention of acute and recurrent ankle sprain. British Journal of Sports Medicine, 2017; 51(2): 113-125.
- World Health Organization (WHO): International Classification of Diseases (ICD-11), Musculoskeletal Injuries. Geneva, 2022.
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