Sprained Ankles: A General Introduction
We all have a common enemy— It lurks around at all times, especially around athletes. It has no respect for others, no regard for others, and especially, no sympathy for others. It acts as a thief: stealing away one’s ability to play a sport or even walk, and has a way of making it seem like it's the victim’s fault… maybe it is. Somehow, it chose me as its next target. It was November 5th on a jolly afternoon, when I was on my 7-mile long run. BAM!! I fell on the ground. I knew right away I had become a victim of it… a victim of a sprained ankle. It’s not all that bad though. There are various causes, symptoms, prevention tips, and treatments that allow us to gain a deeper understanding of a sprain and recover from it.
What is a sprained ankle?
A sprained ankle occurs when unusual movement tears or stretches the bands of tissue (ligaments) in an awkward way. This weakens the connection that holds the ankle bones together, leading to excessive swelling and weakened ankle strength. Ankle sprains most commonly affect the posterior talofibular, calcaneofibular, and anterior talofibular ligaments.
What are the classifications of sprained ankles?
There are two general classes of sprained ankles: Anatomic (the degree of tear/damage to ligaments) and Functional (a patient’s ability to walk or put weight on injury
Anatomic Classifications
Grade I ankle sprain – lateral ligaments are overstretched
Grade II ankle sprain – tearing of one or several of these tissues
Grade III ankle sprain – complete tear of one or more of the lateral tissues
Functional Classifications
Grade I injury – the patient is able to fully put weight and walk
Grade II injury – the patient walks with a noticeable limp
Grade III injury – the patient can’t walk
These classifications can be used to predict the time of recovery for a patient
What are common causes of a sprained ankle?
General causes:
1. Awkwardly landing on your foot after jumping or pivoting
2. Walking or running on uneven surfaces
3. Activities that involve sudden changes in movements
4. Wearing improper footwear that cause a lack of support
5. Non-contact injuries: Injuries that occur without a direct contact from a person such as sudden acceleration, pivoting, or twisting movements.
6. Contact injuries: Injuries that occur due to direct contact such as stumbling onto a person while running and twisting your ankle
7. Overextension: When the ankle is extended beyond its normal range
8. Weak muscles: Insufficient strength in the ankle leading to common injuries
Inversion vs. Eversion
Inversion is the tilting of the sole inward from the midline of the foot. Eversion is the tilting of the sole away from the midline of the foot. A "high" ankle sprain refers to the overstretching or potential tearing of the ligaments that link the lower leg bones (tibia and fibula) right above the ankle joint.
What are the symptoms of a sprained ankle?
Although signs and symptoms vary from person to person, they generally include:
1. Excessive pain during/after weight bearing
2. Tenderness when the ankle is touched
3. Noticeable swelling and bruising in the affected region
5. Restricted range of motion as pain occurs during movement
6. Instability in the ankle such as continuous injuries
7. Popping sensation or sound at the time of injury
What are the treatment options?
Within the first 48 hours, it is important to administer the rice method. However, according to recent studies, it has been proven that the rice method could in fact hinder healing beyond the first 48 hours. Depending on the severity of the injury, this time frame can vary. Here you have the common and well known RICE method— rest, ice, compress, and elevate.
1. Rest and protect the injured area. Remember, sleep is the key!
2. Place a cold pack of ice on the injured area to stop and slow down the swelling
3. Compress or wrap the injured area to stop the swelling through a brace
4. Although this is most commonly ignored, it is important to keep the injury elevated from 6 to 10 inches above the heart. This also lowers swelling and pain.
There are various known treatment options that vary based on degree. For simplicity, let's split it into the three grades presented in the anatomic sections.
Grade I ankle sprain – Administer the RICE method for the first 48 hours, beyond that it is important to get into heating treatments. For example, you can use mildly warm water to place your injury in, which will help increase blood flow and aid the overall healing process. The heating process can be applied for 10-20 minutes in bi-hourly cycles depending on the intensity of the heat. Anti-inflammatory medications are not necessary but can be taken upon consultation with your doctor.
Grade II ankle sprain – Similar to Grade 1, administer the RICE method for the first 48 hours and go into the heating methods afterwards. Anti-inflammatory drugs such as ibuprofen and aspirin can be used to ease the pain upon consultation from the doctor.
Grade III ankle sprain – Although Grade 1 and 2 are similar in treatments, Grade 3 varies a lot. Grade 3 sprains pose a risk of enduring ankle instability. In severe cases, a physician might opt for immobilization using a cast or walking boot. To enhance ankle strength and mobility, rehabilitation could be recommended. Although surgery is not common, competitive athletes or those with recurrent ankle sprains might require surgical ligament repair based on their doctor's evaluation.
Recovery Process
The recovery time for a sprained ankle depends from person to person. For simplicity, we can split the categories into the anatomic grade categories.
Grade I - low-grade injuries can take up to one to three weeks to heal. Although this is a long time, it isn’t the worst possible case as athletes can usually start activity in a month or so.
Grade II - these injuries can take between five to ten weeks to properly heal. It is important to maintain the treatments throughout this time just like every other type of sprain.
Grade III - these injuries can take anywhere from two months to six months to heal. However, some injuries could take years depending on the degree of injury. It is important to consult your doctor before making any decision.
A sprained ankle is a challenging injury that can have a significant impact on an individual’s life, especially for those involved in sports and other activities. Understanding these causes, symptoms, treatments, and recovery methods can help individuals make informed decisions and seek appropriate medical attention for the injuries. With the right treatment, dedication, and consultation, many individuals can recover from these injuries and go back to their normal lives. If you suspect a sprained ankle, it is very very important to consult a professional doctor before making any heavy decisions.
image shot at Ara Ha
