What is an ankle sprain?

The word sprain describes a condition of a ligament when it is overstretched, partially torn, or completely torn off of one of the bones it is normally attached to. 

How are ankle sprains treated? 

When you experience a twisted ankle, there are many things that your doctor will be examining to provide you with the optimal treatment plan.

  • At your initial visit for an ankle sprain, your doctor will perform a thorough evaluation of your ankles.  Assessing both ankles allows a comparison of “normal” to “injured.”  Examining the extent of swelling, bruising, pain and even looseness of the ankle gives your doctor a clue to the severity of the injury.  X-rays are taken at your first visit in order to assess for any damage to the bones in the ankle.  There are three bones that comprise the ankle joint and any of the three can fracture in an ankle sprain.  Often, xrays of the “good” side will also be taken for comparison.
  • If your x-rays do not show any signs of fracture, the following can be expected in the treatment of your ankle sprain.
    • Anti-inflammatories: Both oral and topical anti-inflammatories are available to reduce the swelling and pain from your injury.  Icing is another way to decrease inflammation and your doctor will provide you with instructions on the appropriate way to ice and for how long.  Another way to help reduce swelling is to wear a compressive sleeve around the ankle and foot to keep fluid from retaining in the ankle.
    • Support
      • Ankle Bracing: In order to provide support to your ankle while the ligaments heal, an ankle brace may be fitted to you and is recommended to be worn at all times while walking and in some cases when sleeping.  Ankle bracing is recommended in low grade sprains.
      • CAM walker: This is a special supportive boot which has more support and allows resting of the ankle from excessive motion.  A CAM walker may be recommended to you in instances where a high grade sprain is present.
    • Rest: This may prove to be the most difficult recommendation to follow.  Most ankle sprains occur in athletes or while being active.  In order to allow the ligaments of the ankle to heal quickly and with minimal complication later, the ankle has to rest in a neutral position and all activities that place weight on the ankle should be avoided.
  • If your x-rays DO reveal the presence of a fracture in the ankle, your doctor will initiate treatment similarly to as described above, but with the following possible changes:
    • Cast: In instances where a fracture is diagnosed, a cast may be applied to provide the most stability and immobilization possible while the fracture heals.
    • Surgical discussion: Depending on the severity of the fracture, surgery may be indicated to correctly reduce the fracture and place screws or plates to hold the bone in appropriate position as it heals. 
  • After the initial healing, it is vital to train your mind and body to better recover balance when you come close to falling and twisting your ankle.  It is also important to correct the alignment of your ankle and decrease the predisposition to re-sprain.
    • Physical Therapy: There are many different treatments available through physical therapy.  After an ankle sprain, it is important to perform strengthening and gait and balance training.  Physical therapy also offers ultrasound therapy which reduces residual inflammation from the injury and also assists to remodel scar tissue.  If your ankle sprain was of more a mild grade, home therapy and exercises can also be recommended.
    • Custom Orthotics: Having suffered from an ankle sprain, you will be predisposed to sprain the ankle again, especially if your treatment was delayed.  Custom orthotic inserts fit into most any shoes and provide stability and correct the alignment of the foot under the ankle to reduce the future likelihood of re-sprain.
Dr. Misty McNeill
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D.P.M. - Founder of Prairie Path Foot and Ankle Clinic