> Ankle Sprain
The ligaments on each side of
your ankle joint, which attach all the bone structures
in your ankle to each other, are commonly injured in
an ankle sprain. The bony bumps on the sides of your
ankle are connected to each other by ligaments and also
attach to the your anklebone (talus) and the heel bone
(calcaneous). An ankle sprain is one of the most common
sports injuries. When a twisting or rolling force bends
your foot too far in any direction, the ligaments that
hold the joint in place can be stretched past their
normal position and the tissue can be damaged. The ligament
can pull off its attachment to the bone, the bone can
break, or the middle of the ligament can tear or stretch.
The two ankle ligaments most commonly sprained are called
the anterior talofibular ligament, which connects your
talus to your smaller lower leg bone (fibula), and the
calcanealfibular ligament, which connects your fibula
to your heel bone. Physicians often rate the severity
of ankle sprains with a three-point scale that is based
on the amount of ligament damage:
I: Stretched ligaments.
II: Partially torn ligaments.
III: Completely torn ligaments.
In the majority of ankle sprains, people
twist their ankles inward (inversion), damaging the
ligaments on the outside of the ankle. Ankles are less
frequently sprained by an outward (eversion) ankle twist
that damages the ligaments on the inside of the ankle.
It also is possible to sprain your ankle by bending
your foot too far up or down. In some cases, ligaments
on both the outside and inside of your ankle can be
Ankle sprains often result from a fall or tackle in
contact sports like football, or awkward landing in
sports like basketball, soccer, and volleyball. Any
activity that involves side-to-side motion, like tennis
or racquetball, can put you at risk for an ankle sprain.
Walking or running on uneven, rough surfaces, or taking
an step on an unexpected rock or hole, can sprain your
ankle. Shoes that do not fit properly, or that do not
provide enough side-to-side support when needed, may
increase the risk of an ankle sprain. Poor muscle strength
and conditioning in the lower leg and foot can leave
your ankle too weak to withstand the stress of any abnormal
movements that you may encounter. Overuse or previous
injury may weaken your ankle strength, hindering your
ability to perform stressful ankle movements without
risking a sprain. Starting a new sport or increasing
the intensity of your activities can put new strain
on your ankle that may damage the ligaments.
Most ankle sprains heal with
the R.I.C.E. (rest, ice, compression, and elevation)
and physical therapy. However, your primary physician
may refer you to an orthopedic specialist if you experience
any of the following symptoms:
popping, snapping, or tearing sensation when the injury
significant, persistent swelling or pain in the area.
instability when trying to put weight on the ankle.
If you suffer severe pain and are unable to move your
ankle, see your physician as soon as possible after
the injury. If not treated properly, an ankle sprain
can weaken ligaments, which can hinder your ability
to participate in activities later in life. People who
suffer multiple ankle sprains may have a chronic ankle
weakness that needs special medical attention. Surgery
usually is performed after you have tried conservative
treatments yet continue to suffer ankle sprains. However,
surgery may be necessary soon after a severe, Grade
Though many people with mild or moderate ankle sprains
feel they can treat themselves at home, you should have
your ankle evaluated by a physician, who can check for
complications and decide on a specific treatment program
for your ankle. There usually are three parts to an
orthopedic evaluation: medical history, a physical examination,
and tests that your doctor may order.
Your physician likely will ask about your activities,
which may have caused the ankle sprain, and inquire
as to when the soreness or pain began. If you have had
any prior ankle injuries, your physician will ask about
the treatments you have tried in the past. You should
reveal any history of ankle surgeries at this time.
You will probably be asked how long the ankle took to
begin swelling, whether you were able to continue playing
after the injury, and, if you stopped playing, whether
you required assistance to leave the field. You may
also be asked about your physical and athletic goals
¡V information that will help decide what treatment
might be best for you in achieving those goals.
Your physician usually can make an early assessment
of an ankle sprain by feeling around the injured area.
While asking you questions to pinpoint your pain, he
typically will test ligament strength and check your
ankle's range of motion. Each ligament in your
ankle is usually pressed and manipulated to pinpoint
the exact location of the sprained tissue. After ruling
out other injuries, your physician usually determines
the grade (I to III) of the sprain.
Should your physician require a closer look, these imaging
tests may be conducted:
taken from different angles may be used to rule out
(magnetic resonance imaging) uses magnetic waves to
create pictures of your ankle that let physicians examine
ankle ligaments, cartilage, and tendons.