Ankle Sprain
What is a sprained ankle and how can a podiatrist help?
Ankle sprains are common injuries that can affect people of all ages. In fact, we see many of them at our clinic. While most ankle sprains are usually minor injuries that heal with rest, sometimes the injury may be more complex and increase your risk for further injuries. The good news is that we can help. Not only can we treat your initial injury and help you get back on track, but we can also advise you on the best way to prevent further injuries in the future.
Read on to learn more about ankle sprains, what the best first aid treatment is and why it’s important to visit a podiatrist for further treatment.
The anatomy of the ankle
The ankle joint is made up three bones:
- Tibia (shin bone)
- Fibula (the thinner bone next to the tibia)
- Talus (a foot bone that sits above the heel bone)
The ankle joint allows you to move your foot up and down, while the subtalar joint (the joint that sits below the ankle joint), allows the foot to move from side to side. These joints are surrounded by ligaments (fibrous, connective tissue) which connect the bones together and provide stability to the ankle.
What is an ankle sprain?
Ankle sprains occur when these ligaments stretch too far and tear. One or more ligaments can be affected, depending on the severity of the sprain. Most of the time, sprains occur in the lateral ligaments (the ones on the outside of the ankle). Sprains can range from mild (minimal stretching and no tearing of the ligament) to severe (full tear or rupture of the ligament).
Is a sprained ankle the same as a twisted ankle?
Many people use the terms ‘twisted ankle’ and ‘sprained ankle’ interchangeably but there are slight differences. A twisted ankle occurs when you step the wrong way and experience a brief surge of mild pain, but are able to ‘walk it off’. Twisted ankles don’t require any medical intervention.
Signs and symptoms of a sprained ankle?
A sprained ankle is similar to a twisted ankle, but the degree of the injury is more severe. Spraining an ankle involves stretching or even tearing the ligaments in the ankle. A sprained ankle can be quite painful — something you can’t ‘walk off’. Other symptoms of an ankle sprain include:
- swelling
- bruising
- tenderness
- ankle instability
- inability to weight-bear fully.
What causes sprained ankles?
Ankle sprains happen when you unexpectedly twist your foot. This can occur during any kind of activity but most commonly when:
walking or exercising on a surface that’s uneven
wearing improper shoes for your activity, or shoes that don’t fit well
someone else stepping on your foot, causing you to twist or roll to the side (usually during sport).
falling
playing sport that requires rolling or twisting actions of the foot (e.g. basketball, soccer, football, running, tennis, volleyball etc.)
Who is at risk of developing a sprained ankle?
Everyone is at risk of spraining an ankle but you’re more at risk if you engage in any of the activities listed above. Your risk is also greater if you’ve experienced a previous ankle sprain, or if your heel naturally turns more inward, a condition known as hindfoot varus.
How is an ankle sprain diagnosed?
A podiatrist can often diagnose your ankle sprain through a physical examination to determine range of motion and which ligaments are injured. However, in some cases, it may be necessary to undergo imaging tests such as:
X-rays
to determine if any bones have been fractured
MRI
to look for severe ligament, cartilage, or bone injury
Ultrsound
to investigate ligament stability
Severity of ankle sprains
Ankle sprains can vary in their severity and are graded according to how much damage has been done to the ligaments.
A Grade 1 mild sprain is characterised by mild tenderness and swelling around the ankle, with slight stretching and microscopic tearing of the ligaments.
Moderate Grade 2 sprains involve partial tearing of the ligament, moderate tenderness and swelling, and abnormal looseness around the joint when the ankle moves in certain ways.
A Grade 3 sprain is a severe sprain that involves a complete tearing of the ligament, significant tenderness and swelling, and substantial instability of the ankle.
How long is sprained ankle recovery time?
Of course, everyone’s situation is different but on average recovery times for an ankle sprain are as follows:
Grade | Recovery time |
|---|---|
Grade 1 | 1-3 weeks |
Grade 2 | 3-6 weeks |
Grade 3 | several months |
Factors such as damage to the ligament and instability of the ankle joint will impact healing times.
Complications of ankle sprains
If you sustain an ankle sprain you should see a clinician. Without proper treatment and rehabilitation, an injured ankle may not heal properly, and may lead to loss of range of motion and stability. This increases the likelihood of injuring it again in the future. Recurrent sprains can also cause long-term complications including chronic pain, arthritis and ongoing ankle instability.
Ankle sprain treatment
Fortunately, almost all ankle sprains will heal without the need of surgery. However, the healing time will vary according to how severe the injury is.
home treatment
Immediate treatment for a suspected ankle sprain is designed to reduce pain and swelling and to protect the ligaments from further injury. The best course of treatment is to adopt the PRICE treatment protocol and reduce HARM to your ankle.
Podiatry treatment
Podiatrists are well-trained to manage and treat sprained ankles. In the acute period we can assist with taping to immobilise the joint in order for it to heal, and to prevent further injury to the ligaments and joint.
We can also help with the rehabilitation process by advising you on exercises to improve the mobility of the joint and strengthen the muscles surrounding the ankle. We can also provide you with exercises and strategies to help prevent re-injury in the future. This may include:
- exercises to improve your balance
- advice on taping or ankle braces when playing sport
- advice on the best footwear to help reduce the chances of another sprain or injury
- functional orthotics to support your ankle
How to prevent sprained ankles
While it’s not always possible to prevent a sprained ankle, there are many things you can do to reduce your risk. These include:
- warming up before you exercise or play sport
- wearing appropriate shoes for the activity you’re doing
- avoiding walking or running on uneven surfaces
- wearing an ankle brace or support if you have injured your ankle before
- improving your balance and stability.
Ankle sprains don’t have to sideline you forever. Seek immediate treatment even if you feel your injury is minor. Because left untreated, what may be a minor injury may turn into a bigger problem.
frequently asked questions
We recommend avoiding sports for in the first 72 hours following a sprained ankle.
You can fly with sprained ankle. Remember to keep it elevated and wear a bandage to help with compression.
There are no shortcuts to recovery. Following PRICE and HARM in the first 72 hours can reduce symptoms.
No, you don’t need an x-ray for sprained ankle unless you are unable to weight bear on it and your symptoms are worsening.
Depending on the grade, sprained ankles can take between 2 weeks to several months to heal.
We recommend no massage when you are ankle is sprained.
It’s impossible to heal a sprained ankle overnight, you can reduce symptoms with PRICE.
Swelling can last for two weeks.
We recommend no heat on sprained ankles.
Minor sprains or Grade 1 sprains can take 3 weeks to heal.
Yes, in the acute phase walking on your ankle can make it worse. Protect your ankle in the first few days using crutches to help improve your recovery and avoid further harm.
Apply an ice pack for 15-20minutes every 2-3 hours. Avoid placing ice directly to your skin and wrapping in a towel.
In the initial phase avoid running on your sprained ankle. As you return to support consider wearing an ankle guard or strap until your ankle has fully recovered.
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