Sprained Ankle: Causes, Types, and Treatment - Thomson Medical

What is a sprained ankle?

A sprained ankle is a common injury that affects the ligaments that provide stability to the ankle joint. This injury often happens when the ligaments are overstretched or torn due to rolling or twisting movements that exceed their normal range of motion.

An ankle sprain usually involves the ligaments on the outside of the ankle, which can result in severe pain and swelling, making daily activities difficult.

Sprained ankle causes

An ankle sprain is a common sports injury because during these activities, the ligaments surrounding the ankle could get overstretched or torn. This is particularly true for activities that include rapid directional changes, jumping, or contact sports.

Here are some causes of ankle sprains, such as:

• A fall that causes the foot to twist either inward or outward.

• Landing awkwardly on your foot after jumping or pivoting.

• Accidentally twisting the ankle when changing direction in quick succession.

• Exercising on an uneven surface.

In addition to the aforementioned causes, several other risk factors can increase the chances of this injury, including:

• Sports participation:

  • Participating in sports that require jumping, cutting action, rolling, or twisting of the foot can increase the risk of sprain.

  • These sports include basketball, tennis, football, and trail running.

• Prior injury:

  • If you had sprained your ankle in the past, you are more likely to have recurrent sprains.

• Poor physical condition:

  • Poor muscle strength or flexibility in the ankle may increase the risk of a sprain when participating in sports.

• Improper shoes:

  • Shoes that don't fit properly to your foot or aren't suited for your specific exercise increase the chances of a sprain.

Common types of ankle sprain

Actively participating in physical activities that place stress on ankle ligaments can make them vulnerable to injury. Below are some common ankle sprain that may occur:

• Lateral ankle sprain:

  • This sprain injury is the most common injury that affects ligaments on the outer side of the ankle. It typically occurs when your foot rolls outward (inversion injury), often happening after an awkward landing position.

• Medial ankle sprain:

  • This type of injury is less prevalent than the lateral ankle sprain and impacts the ligaments on the inner side of the ankle. It typically occurs when the foot rolls inward, known as an eversion injury.

• High ankle sprain:

  • This injury can cause severe ligament damage because it involves other ligaments in the ankle. It often occurs from twisting or rotational movements and usually happens in sports such as football.

Common symptoms

A sprained ankle can have different symptoms depending on the severity grade of the injury. Here are some common symptoms of the sprain, such as:

• Pain when moving the foot.

• Swollen ankle and bruising.

• Limited range of motion.

• Difficulty walking on the affected foot.

• Instability in the ankle, which reduces strength.

If the symptoms of this injury are getting worse over time, don’t hesitate to request an appointment with our specialists at Thomson Medical for an accurate diagnosis and personalised treatment plan.

Diagnosis of sprained ankle

To begin diagnosing this injury, your doctor will first ask about your symptoms and how this injury happened. The doctor may also ask about any physical activity you do and if you recently increased the intensity of these activities.

They may then review your medical history and conduct a physical examination of your ankle, foot, and lower leg. Here are some physical examinations that the doctor could do, such as:

• Palpation:

  • This physical examination aims to check for tenderness in the injured by gently pressing around to discover which ligaments are injured.

• Range of motion assessment:

  • This test involves moving your foot in various directions to check the ankle range of motion. 

• Stability testing:

  • To assess the stability of the ankle joint, the doctor will manipulate or pull your foot in several directions. 

In addition to that, to get a better diagnosis, healthcare professionals can perform imaging tests like X-rays, magnetic resonance imaging (MRI), and CT (computed tomography) scans to help healthcare providers understand, diagnose, and treat your specific injury.

Ankle sprain severity grades

This injury is categorised into 3 severity grades, each reflecting the extent of damage to the ligament following an injury.

• Grade 1 (mild): 

  • The ligament is stretched without any noticeable tearing. There's mild pain and swelling, allowing you to walk with only slight discomfort.

• Grade 2 (moderate): 

  • The ligament has suffered a partial tear, leading to increased swelling, pain, and bruising. While walking becomes significantly more difficult due to the increased pain, it's still possible.

• Grade 3 (severe): 

  • The ligament is fully torn, resulting in a severe ankle sprain, pain, swelling, extensive bruising, and an inability to walk without experiencing significant discomfort.

Treatment options

Treatment for ankle sprain depends on the severity of the injury. If the injury is mild (grade 1), it’s possible to treat this injury at home. But if the injury is severe (grade 3), such as a complete tear of a ligament, surgery may be necessary.

Mild Injury (grade 1)

For a grade 1 sprain where the ligament is overstretched but not torn, self-treatment is typically sufficient. The recommended approach includes:

• R.I.C.E method

  • Rest: Avoid using the injured foot to avoid worsening the damage and allow it to rest and heal properly.

  • Ice: Apply an ice pack to help alleviate swelling and discomfort. Aim to do this for 15-20 minutes every 1-2 hours during the first 48 hours.

  • Compression: Use an elastic bandage to wrap the injured ankle to help reduce swelling.

• Elevation: 

  • Elevate the injured foot above heart level when possible to help reduce swelling.

• Medications:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen can reduce pain and inflammation. 

Moderate injury (grade 2)

A grade 2 sprain involves partial tearing of the ligament and requires professional treatment, such as:

• Using an ankle support brace:

  • This equipment functions to help stabilise the joint and prevent further injury during the healing process.

• Physical therapy:

  • For more severe sprains, particularly when there is considerable loss of function, physical therapy can help to regain strength and flexibility.

  • A physical therapist can help to create a set of exercises tailored for you to help the healing process.

Severe injury (grade 3)

If the ligament is completely torn and does not improve or heal properly with non-surgical treatments, surgical intervention may be necessary to repair or reconstruct the damaged ligaments.

When do I need to see a doctor?

Seek immediate care if you experience any of the following symptoms after a sprained ankle: 

• Feeling pain when trying to walk.

• Noticeable deformity or misalignment of the injured area.

• Swelling, bruising, or pain does not improve with basic treatment.

• Persistent instability or weakness even after a few days of rest.

• If you suspect a fracture or significant ligament injury.

To seek professional help for ankle injuries, request an appointment with our specialists at Thomson Medical.

Injury prevention steps

A sprained ankle is not entirely preventable, especially if it resulted from an activity or accident you cannot avoid. Here are some steps you can take to lower your risk of this injury, including:

• Strengthening muscles: 

  • Regular exercises like calf raises, resistance band exercises, and balance training (e.g., standing on one foot or using a wobble board) can help to improve strength, balance, and ankle flexibility.

• Use proper footwear: 

  • Wear shoes with a good fit that can support your foot well, especially during sports or activities that involve quick movements.

• Taping or bracing: 

  • For athletes or individuals that had previous injuries, using an ankle brace or tape during activities can help provide additional support.

• Warm-up and stretching: 

  • Proper warm-up before exercise and stretching afterward can help reduce the risk of sprains as it improves flexibility.

• Avoid uneven surfaces: 

  • Be cautious when exercising on slippery or uneven terrain.

• Balance training: 

  • Activities like standing on one leg or using a balance board can improve proprioception (the body’s sense of joint position) and reduce injury risk.

Complications of a sprained ankle

In most cases, mild to moderate sprains heal completely without any lasting effects. However, failing to seek proper treatment or if the ankle is frequently re-injured can result in:

• Chronic ankle instability, which can cause joint stability issues.

• Arthritis or osteoarthritis, especially if the sprains happen repeatedly.

• If the sprain is not rehabilitated properly, persistent pain, reduced range of motion, and future ankle sprain may occur.

FAQ

How long does it take to heal a sprained ankle?

Recovery times for a sprained ankle can vary based on the severity of the injury. For a mild sprain (grade 1), healing typically takes about 1-2 weeks. A moderate sprain (grade 2) may require approximately 3-6 weeks for recovery. Lastly, a severe sprain (grade 3) can take anywhere from 6 to 12 weeks to fully heal.

Is walking good for a sprained ankle?

If done properly and with the appropriate support, walking on a sprained ankle can actually aid in its rehabilitation. However, the injury could worsen if you're overdoing it and ignore the pain that may arise.

What to do if I have a sprained ankle?

If you accidentally fall and suspect that you have a sprained ankle, there are several steps you can take, including:

• Follow the RICE method as an initial treatment.

• Once swelling decreases, engage in gentle range-of-motion exercises to maintain flexibility and prevent stiffness in the ligament.

• After initial recovery, participate in strengthening exercises. Begin with simple movements and progressively incorporate more challenging activities, such as resistance training and balance exercises.

• While recovering, refrain from activities that could worsen the injury, such as running or jumping.

• Make an appointment with a medical professional for a structured rehabilitation program, especially if the sprain is moderate to severe. They can guide you through exercises designed to restore strength and stability in the ankle.

The information provided is intended for general guidance only and should not be considered medical advice. For personalised recommendations and tailored advice, please consult a specialist at Thomson Medical. Book an appointment with Thomson Medical today.