How to Identify and Care for Sprained Ankles

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Sprained ankle

Did you know that around 25,000 people sprain their ankle each day? Ankle sprains are surprisingly common injuries that can happen to people of all ages.

Our team has the expertise to help you know the signs of a sprained ankle and when it’s time for treatment. Rebound orthopedic surgeon Dr. Jay Crary has extensive experience treating foot and ankle injuries. He provides tips below on how to care for sprained ankles.

What is a Sprained Ankle?

Like most injuries, a sprained ankle can be very moderate, causing minimal pain or severe and make walking and standing difficult or painful. An ankle sprain is an injury that happens when the ankle is forced from its natural position, rolling inward or outward.

“Typically, when you sprain your ankle, you tear or stretch the ligaments that surround the outer side of your ankle,” says Dr. Crary. “Ankle sprains vary greatly, from mild injury that will have minimal recovery time, to severe damage that can ultimately necessitate surgery.”

Common Causes of Sprained Ankles

All ankle sprains involve twisting of the foot, causing damage to the ligaments of the ankle. Inversion ankle sprains are the most common type and are caused by twisting the foot inward, resulting in damage to the outer ligaments as they are stretched. Eversion sprains, caused by twisting the foot outward, usually cause more severe damage to the inside ankle ligaments.

The American Academy of Orthopaedic Surgeons classifies sprains in three grades, as featured below in their chart:

 

Severity Physical
Examination
Findings
Impairment Pathophysiology Typical Treatment*
Grade 1 Minimal tenderness and swelling Minimal Microscopic tearing of collagen fibers Weight bearing as tolerated

No splinting/castingIsometric exercises

Full range-of-motion and stretching/ strengthening exercises as tolerated

 

Grade 2 Moderated tenderness and swelling

Decreased range of motion

Possible instability

Moderated Complete tears of some but not all collagen fibers in the ligament Immobilization with air splint

Physical therapy with range-of-motion and stretching/ strengthening exercises

Grade 3 Significant swelling and tenderness

Instability

Severe Complete tear/ rupture of ligament Immobilization

Physical therapy similar to that for grade 2 sprains but over a longer period

Possible surgical reconstruction

What Should I Do If I Have These Symptoms?

“Because it can sometimes be difficult to tell the difference between a sprain and broken ankle, it’s important to get an examination, which usually includes routine x-rays. Occasionally, additional studies such as a CT scan or MRI are necessary if more damage is suspected,” says Dr. Crary. “Our team definitely recommends paying a visit to a physician if you are experiencing pain, swelling and are unable to walk.”

How to Care for Sprained Ankles by the Grade

For Grade I sprains, our providers recommend following the R.I.C.E. method: rest, ice, compression and elevation.

“For Grade I sprains, we usually recommend patients weight bear within the limits of pain. If putting weight on the foot does not hurt much, then using the ankle will facilitate healing and functional recovery. Often a brace or even a boot is helpful.”

Click here to see our guide on when to ice and heat injuries.

For Grade II sprains, our providers may immobilize the ankle with a splint or brace, while also recommending that you adhere to the R.I.C.E. method.  Similar to Grade I sprains, Rebound doctors allow patients to weight bear and move the ankle as soon as they are able. Such functional rehabilitation programs can decrease the length of disability and improve long-term function.

Grade III sprains are the most challenging to treat. Often they require immobilization in a boot for a period of several weeks. Still, our team recommends early weight bearing in the boot if it can be done with minimal pain. Strengthening of the muscles is done as soon as it is tolerated.

“Another big part of the healing process is to think of your treatment or care in phases,” says Dr. Crary. “By rehabilitating your ankle in phases, you better your chances of it healing fully.”

The American Academy of Orthopaedic Surgeons suggests three phases for rehabilitation:

  • Phase 1 includes resting, protecting the ankle and reducing the swelling
  • Phase 2 includes restoring range of motion, strength and flexibility
  • Phase 3 includes gradually returning to activities that do not require turning or twisting the ankle and doing maintenance exercises. This will be followed later by being able to do activities that require sharp, sudden turns (cutting activities) such as tennis, basketball or football (weeks to months).

If you believe you have sustained an ankle sprain, please do not hesitate to speak with a physician and receive an examination. You may contact us at 1-800-Rebound to visit with an ankle specialist.

Related Rebound Resources:

When to Ice or Heat an Injury

How to Know the Difference Between Soreness and Pain

Ankle Fractures: Causes, Symptoms and Treatments

Foot and Ankle Stress Fractures

Trusted Sources:

American Academy of Orthopaedic Surgeons (AAOS) – Sprained Ankle

AAOS – Foot and Ankle Exercise Conditioning Program

American Orthopaedic Food & Ankle Society (AOFAS) – How to Care for a Sprained Ankle