Ligaments help stabilize the ankle joint and prevent excess motion. Ankle injuries occur when ligaments are stretched beyond their normal range of motion and the ankle moves in an awkward motion beyond the normal range of that joint. The most common mechanism of ankle sprain is a combination of plantarflexion and inversion, or a downward-inward motion of the foot about the ankle.
When this takes place, the 3 main outer ankle ligaments stretch or tear depending on the severity. With severe ankle injuries, fractures and joint displacement can occur.
Ankle sprains are graded based on the severity and degree of ligamentous injury.
- Grade 1: Partial tear of a ligament
- Grade 2: Incomplete tear of a ligament with moderate functional impairment
- Grade 3: Complete tear and loss of integrity of a ligament
Ankle sprains present with pain to the outer ankle area. Bruising and swelling may occur. There will be pain and tenderness on palpation, weight bearing, and joint motion. Range of motion of the ankle and foot will also be limited.
Diagnosis: How is an ankle sprain diagnosed?
Ankle sprains are evaluated with a careful history and thorough physical exam. In conjunction with a good history and physical, there are other in-office diagnostic modalities in which we can further evaluate ankle sprains. Digital X-Rays are done in-office to rule out any bone injury and can instantly be reviewed with the patient. For severe ankle trauma, or when conservative therapy is not effective, a CT or MRI scan will allow for proper visualization of both bone and soft tissue allowing for the proper treatment course to be implemented.
Treatment: Treatments for an ankle sprain
Immediate treatment for ankle sprains includes Rest, Ice, Compression, and Elevation. Limiting physical activity. Non-steroidal anti-inflammatory drugs can help alleviate the pain and reduce swelling. In moderate tears an ankle stabilizing brace can help support the ankle and reduce pain until physical therapy can help strengthen the tendons and ligaments. In some severe cases, a CAM boot will be recommended if patients are unable to bear weight.
Physical therapy along with muscle strengthening and range of motion exercises will aid in the treatment of ankle sprains and assist in restoring full function after an injury.