Ankle Sprains

Ankle sprains are the most common acute orthopedic injury. They can happen while exercising or just stepping off a curb, into a hole or on uneven ground. It's not unusual for them to have happened before, sometimes on multiple occasions. The typical ankle sprain results in a stretching or tearing of the small ligaments that are on the outside or lateral aspect of the ankle.

The patient usually presents with a history of their ankle "turning."   Sometimes a "pop" or "snap" is felt or heard. After the injury, there is usually difficulty with walking. There is swelling and discoloration (black and blue) over the outside part of the ankle. There can be instability noted on the "drawer test", which is when we gently move the heel structures forward and back as the leg is stabilized. Range of motion in the ankle can be limited secondary to pain and swelling but strength is not usually affected.

Even though an x-ray of a sprain is usually negative, it is essential in order to rule out a fracture. Treatment of sprains and fractures are quite different. Some Ankle fractures are unstable and need surgery to fix the fracture.

Sprains of the ankle are divided into three types.  Grade 1 is a minor injury and grade 3 is a sever injury with complete tearing of the ankle ligaments. 

We believe for acute ankle sprains, the best initial treatment is ice, elevation, anti-inflammatory medications, and physical therapy.  For a Grade 1 or minor sprain these measures will suffice.  Occasionally, bracing the ankle gives some extra support and allows the patient more confidence while ambulating or exercising.

More severe sprains that have greater instability and tearing of the ligaments should be placed in a brace and, occasionally, a cast, to allow the injured structures to heal.

In the long run the best treatment of ankle sprains is prevention. This means when you're doing activities that have a high incidence of ankle injuries, wear a brace or get your ankle taped so you won't sprain it. Braces are relatively inexpensive and easy to use. Taping works well but requires someone available who is well trained to apply it appropriately.

Activities such as basketball, volleyball, soccer, tennis, and other sports requiring a lot of stopping, starting and twisting motions have a high incidence of ankle injuries. Beware of uneven and pot-holed playing fields

In our opinion, surgical intervention for acute or chronic ankle instability is only occasionally needed. If you have problems with your ankle and chronic sprains, an orthopedic surgeon should evaluate you.