Ankle Sprain

A sprain is a very common ankle injury. A sprained ankle can happen to athletes and non-athletes, children and adults. It can happen when you take part in sports and physical fitness activities. It can also happen when you simply step on an uneven surface, or step down at an angle. Having a better understanding of the causes and symptoms of ankle sprain can help you take preventive measures and decide on what treatment to undertake.

Ankle Sprain Nonsurgical Treatment

Walking may be difficult because of the swelling and ankle pain. You may need to use crutches if walking causes pain. Usually swelling and pain will last two days to three days. Depending upon the grade of injury, the doctor may tell you to use removable plastic devices such as castboots or aircast walkers.

Most ankle sprains need only a period of protection to heal. The healing process takes about four weeks to six weeks. The doctor may tell you to incorporate motion early in the healing process to prevent stiffness. Motion may also aid in being able to sense position, location, orientation and movement of the ankle (proprioception). Even a complete ligament tear can heal without surgical repair if it is immobilized appropriately. Even if an ankle has a chronic tear, it can still be highly functional because overlying tendons help with stability and motion.

Initial treatment = R.I.C.E (rest, ice, compression and elevation):

• Rest your ankle by not walking on it.
• Ice should be immediately applied. It keeps the swelling down. It can be used for 20 minutes to 30 minutes, three or four times daily. Combine ice with wrapping to decrease swelling, pain and dysfunction.
• Compression dressings, bandages or ace-wraps immobilize and support the injured ankle.
• Elevate your ankle above your heart level for 48 hours.

Rehabilitation is used to help to decrease pain and swelling and to prevent chronic ankle instability problems. Ultrasound and electrical stimulation may also be used as needed to help with pain and swelling. At first, rehabilitation exercises may involve active range of motion or controlled movements of the ankle joint without resistance. Water exercises may be used if land-based strengthening exercises, such as toe-raising, are too painful. Lower extremity exercises and endurance activities are added as tolerated. Proprioception training is very important, as poor propriception is a major cause of repeat sprain and an unstable ankle joint. Once you are pain-free, other exercises may be added, such as agility drills. The goal is to increase strength and range of motion as balance improves over time.

Medication for Ankle Sprain

Nonsteroidal anti-inflammatory drugs (NSAIDs) may be used to control pain and inflammation.

Long-term outcome of Ankle Sprain

If an ankle sprain is not recognized, and is not treated with the necessary attention and care, chronic problems of pain and instability may result.

Ankle Sprain Surgical Treatment

Surgery is reserved for injuries that fail to respond to nonsurgical treatment, and for persistent instability after months of rehabilitation and non-surgical treatment.

Surgical options include:

• Arthroscopy
  An ankle surgeon looks inside the joint to see if there are any loose fragments of bone or cartilage, or part of the ligament caught in the joint
• Reconstruction (ankle ligament reconstruction)
  An ankle surgeon repairs the torn ligament with stitches or suture, or uses other ligaments and/or tendons found in the foot and around the ankle to repair the damaged ligaments

Ankle Sprain Rehabilitation 

Rehabilitation after surgery involves time and attention to restore strength and range of motion so you can return to pre-injury function. The length of time you can expect to spend recovering depends upon the extent of injury and the amount of surgery that was done.