Ankle Sprains – consultations and treatment options
In the first part of our blog on Ankle Sprains, we looked at the causes and symptoms and how you can identify that you have an ankle sprain. In this next part, we look at the consultation process and what happens when you decide to seek medical attention.
Consultation
At the consultation, the history (how the injury happened and any relevant past medical problems) will be taken by the doctor. The next step is a physical examination by the doctor:
- Palpation: gently pressing around the ankle to determine which ligaments and other structures are injured.
- Range of motion: moving the ankle in different directions.
- Stability: testing the ankle ligaments to see if they are torn.
Investigations
Tests may be ordered by the doctor to complete the diagnosis and find out exactly what damage has occurred:
- X-rays: look at the bones and are useful for showing fractures/broken bones. Sometimes the fracture or break may be subtle such as a hairline fracture and the it may be necessary to get further tests.
- Stress x-rays: These are taken while the ankle is being pushed in different directions and can help to show whether the ankle is moving abnormally because of the torn ligaments.
- Magnetic resonance imaging (MRI) scan: these scans are very good at looking at the soft tissues such as ligaments, tendons or the cartilage of the joint surface. Subtle fractures such as avulsions (small bone chip), hairline fractures and stress fractures which are not visible on an xray may be picked up on the MRI scan.
- Ultrasound: This type of scan helps to observe the ligament directly while your ankle is moved. This allows the doctor to determine how much stability the ligament provides.
Types of ankle sprain
As discussed ankle sprains can range from mild to severe injuries. It is helpful to determine the grade of the sprain in order to develop a treatment plan. Sprains are graded based on how much damage has occurred to the ligaments:
- Grade 1 Sprain (Mild)
What happens: Slight stretching and microscopic tearing of the ligament fibers
Symptoms: Mild tenderness and swelling around the ankle
- Grade 2 Sprain (Moderate)
What happens: Partial tearing of the ligament
Symptoms: Moderate tenderness and swelling around the ankle
- Grade 3 Sprain (Severe)
What happens: Complete tear of the ligament
Symptoms: Significant tenderness and swelling around the ankle
Treatments
Almost all ankle sprains can be treated without surgery in the first instance. Even a complete ligament tear can heal without surgical repair if it is immobilised appropriately.
A three-phase program guides treatment for most ankle sprains:
Phase 1: resting, protecting the ankle and reducing the swelling.
Phase 2: restoring range of motion, strength and flexibility.
Phase 3: maintenance exercises and the gradual return to activities that do not require turning or twisting the ankle. This will be followed later by being able to do activities that require sharp, sudden turns such as tennis, basketball, or football.
This three-phase treatment program may take just 2 weeks to complete for minor sprains, or up to 6 to 12 weeks for more severe injuries.
If you think you have an ankle sprain and you need treatment and medical attention, get in touch with our team to book a free 15-min call and find out how we can help with your recovery.
