Ankle Sprains - Symptoms, Types & Treatments

What is an Ankle Sprain?

An ankle sprain occurs when the ligaments that support the ankle stretch and can tear. Ankle sprains are common injuries that can occur at any age. They range from mild to severe, depending upon how much damage is caused to the ligaments. Most sprains are minor injuries that heal with first aid treatments like rest and applying ice. However, if the ankle is very swollen and painful to walk on and if it is difficult putting weight on the ankle then it is a good idea to see a doctor. Without proper treatment and rehabilitation, a more severe sprain can weaken the ankle making it more likely that it will injure again. Recurrent ankle sprains can lead to chronic (long term) ankle pain, arthritis, and repetitive instability (giving way).

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What causes an Ankle Sprain?

The foot can twist during a variety of activities such as walking or exercising on an uneven surface, in sports that require rolling and twisting of the foot: trail running, basketball, tennis and football, and during sports injuries: another player may step on the foot or tackle causing the foot to twist or roll to the side.

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What are Ligaments?

Ligaments are bands of tough elastic tissue (like a rope) that connect bones to other bones. The ankle ligaments help to keep the bones making up the ankle joint in proper position and stabilise the joint. Most ankle injuries affect the lateral ligaments which are found on the outer of the ankle. Sprains can range from stretching of the fibres that make up the ligament to complete tears.

If there is a complete tear of the ligaments, the ankle may become unstable (give way) after the initial injury phase passes. Over time, this instability can result in damage to the bones and cartilage of the ankle joint.

Kent’s Holistic Foot & Ankle specialists

The Sajid Shariff clinic is a private orthopaedic clinic based in SE London and Kent that specialises in surgical and non-surgical treatment of foot and ankle conditions including ankle sprains, bunions, plantar fasciitis and achilles tendonitis.

Keep an eye on the shape of your feet; if you see changes see a doctor to find out if there are any recommendations to prevent hallux valgus from forming

Strengthen your feet by exercising them

Wear shoes that fit your feet well and offer good support

Try to avoid shoes that have a heel or pointed toe

Investigations & Consultations for Ankle Sprains

Different types of tests may be recommended by a 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) scans

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.

Treatments for Ankle Sprains

RICE (Rest, Ice, Compression, Elevation)

For milder sprains, the simple home treatment follows the RICE protocol:

RICE: Rest Ice Compression Elevate

Rest the ankle by not walking on it.
Ice should be applied as soon as possible to keep the swelling down. Use it for 20 to 30 minutes, three or four times daily. Do not apply ice directly to the skin.
Compression dressings or bandages will support the injured ankle.
Elevate the ankle above the level of your heart as often as possible during the first few days.

Medication: Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen can help control pain and swelling.

Non Surgical Treatments

Some sprains will require treatment in addition to the RICE protocol and medications.

Crutches: In most cases, swelling and pain will last from 2 to 3 days. Walking may be difficult during this time and it may be helpful to use crutches.
Immobilisation: During the early phase of healing, it is important to support the ankle and protect it from sudden movements. For more severe sprains, a removable plastic device such as a boot or a brace can provide support.The doctor may encourage you to put some weight on your ankle while it is protected. This can help with healing
Physiotherapy: Rehabilitation exercises are used to prevent stiffness, increase ankle strength, and prevent chronic ankle problems.
Early motion. To prevent stiffness, physiotherapists will recommend exercises that involve range-of-motion or controlled movements of your ankle without weight or resistance.
Strengthening exercises. Once you can bear weight without increased pain or swelling, exercises to strengthen the muscles and tendons in the front and back of your leg and foot will be the next step. Water exercises may be used if land-based strengthening exercises, such as toe-raising, are too painful. Exercises with resistance are added as tolerated.
Proprioception (balance) training. Poor balance often leads to repeat sprains and ankle instability. A good example of a balance exercise is standing on the affected foot with the opposite foot raised and eyes closed. Balance boards are often used in this stage of rehabilitation.
Endurance and agility exercises. Once you are pain-free, other exercises may be added, such as agility drills. Running in progressively smaller figures-of-8 is excellent for agility and calf and ankle strength. The goal is to increase strength and range of motion as balance improves over time.

Results & Next steps

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.

What are Ankle Sprains and how can they be treated?

What is an Ankle Sprain?

Book a call with one of our team

What causes an Ankle Sprain?

What are Ligaments?

Symptoms of an Ankle Sprain?

Symptoms of Ankle Sprains

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