Ankle Sprain: Causes, Symptoms, and Diagnosis

An ankle sprain is an injury to the tough bands of tissue (ligaments) that surround and connect the bones of the leg to the foot. The injury typically happens when you accidentally twist or turn your ankle in an awkward way. This can stretch or tear the ligaments that hold your ankle bones and joints together.
All ligaments have a specific range of motion and boundaries that allow them to keep the joints stabilized. When ligaments surrounding the ankle are pushed past these boundaries, it causes a sprain. Sprained ankles most commonly involve injuries to the ligaments on the outside of the ankle.
You should call your doctor right away if you sprain your ankle. Your doctor can determine the severity of the injury and recommend a proper course of treatment. It can take several weeks or months for a sprained ankle to heal completely.

An ankle sprain often occurs when the foot suddenly twists or rolls, forcing the ankle joint out of its normal position. During physical activity, the ankle may twist inward as a result of sudden or unexpected movement. This causes one or more ligaments around the ankle to stretch or tear.
Some swelling or bruising can occur as a result of these tears. You may also feel pain or discomfort when you place weight on the affected area. Tendons, cartilage, and blood vessels might also be damaged due to the sprain.
Ankle sprains can happen to anyone at any age. Participating in sports, walking on uneven surfaces, or even wearing inappropriate footwear can all cause this type of injury.

You may have a sprained ankle if you notice the following symptoms in the ankle:
  • swelling
  • tenderness
  • bruising
  • pain
  • inability to put weight on the affected ankle
  • skin discoloration
  • stiffness
The ankle can sustain many different types of injuries. It’s important to see your doctor when you’re experiencing problems with your ankle. Your doctor can determine whether the injury is a sprain or something more severe.

Your doctor will perform a physical exam to determine which ligaments have been torn. During the exam, your doctor may move your ankle joint in various ways to check your range of motion.
Imaging tests, such as X-rays, may also be ordered to rule out a bone fracture. An MRI may be done if your doctor suspects a fracture, a serious injury to the ligaments, or damage to the surface of the ankle joint. The MRI test uses a strong magnetic field and radio waves to create detailed images of the body. This allows your doctor to make a proper diagnosis.

Treating a sprained ankle promotes recovery and prevents further discomfort. It’s important not to put weight on the injured area while you’re recovering from an ankle sprain.

Home treatments

You may be able to treat mild sprains at home. Recommended home care treatments include:
  • using elastic bandages (such as an ACE bandage) to wrap your ankle, but not too tightly
  • wearing a brace to support your ankle
  • using crutches, if needed
  • elevating your foot with pillows as necessary to reduce swelling
  • taking ibuprofen (such as Advil) or acetaminophen (such as Tylenol) to manage pain
  • getting plenty of rest and not putting weight on your ankle
It’s also helpful to apply ice to the injured area as soon as you can to reduce swelling. On the first day, you should apply ice every 20 to 30 minutes, three to four times per day. Afterward, apply ice every three to four hours for the next two days.
Your doctor may tell you to stay off of your injured ankle until the pain subsides. For mild sprains, this may take a week to 10 days, while more severe sprains may take up to several weeks to heal.

Surgery

Surgery for sprained ankles is rare. It may be performed when the damage to the ligaments is severe and there is evidence of instability, or when the injury doesn’t improve with nonsurgical treatment. Surgical options include:
  • Arthroscopy: During an arthroscopy, a surgeon looks inside the joint to see if there are any loose fragments of bone or cartilage.
  • Reconstruction: For reconstruction surgery, a surgeon will repair the torn ligament with stitches. They may also use other ligaments or tendons around the foot or ankle to repair the damaged ligaments.
The type of surgery needed will depend on the severity of your ankle sprain and your activity level. After surgery, rehabilitation is an important part of the recovery process. You’ll need to attend regular follow-up appointments with your doctor and complete physical therapy exercises to regain motion and strengthen the muscle about the ankle. Depending on the extent of your ankle sprain and the type of surgery, rehabilitation can take weeks or months.

In most cases, an ankle sprain isn’t very serious and will completely heal with proper treatment. The amount of time required for a full recovery will depend on the severity of the sprain. Most ankle sprains take a few weeks to fully heal. A more severe sprain may take months.
Although pain and swelling will eventually go away, your injured ankle may not be as stable as your unaffected ankle. Your doctor may suggest certain exercises to help strengthen the muscle about the ankle. However, you shouldn’t proceed with exercises until your doctor has told you to do so.

You can lower your risk for future sprains by:
  • wrapping the affected ankle in an elastic bandage
  • wearing a brace, if necessary
  • performing strengthening exercises
  • avoiding high heels
  • warming up before exercising
  • wearing sturdy, quality footwear
  • paying attention to surfaces you’re walking on
  • slowing or stopping activities when you feel fatigued
Call your doctor right away if you think you’ve sprained your ankle again. When left untreated, an ankle sprain can lead to long-term pain and instability in the ankle.

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