What is an ankle sprain?

An ankle sprain is a stretching or tearing of a ligament which holds the foot to the leg or the leg bones together. These ligaments surround and protect the joint from having excessive or abnormal motion. When a ligament is injured, the joint no longer has the support which it needs. The resulting abnormal motion can cause injury to the cartilage on the bones or other supporting ligaments at that joint.

There are three main types of ankle sprains: lateral ankle sprains, medial ankle sprains, and high ankle sprains.

The most common is a lateral ankle sprain. The lateral ligaments attach the outside ankle bone to the outside of the foot and work to prevent the foot from turning underneath the ankle. They also hold the ankle bone deep within the joint to prevent it from moving forward or backward. The tendons which support the lateral ankle are sometimes injured as well with this condition.

A medial ankle sprain is an injury to the ligament on the inside of the ankle and is associated with more severe injuries and fractures.

High ankle sprain occurs when the ligaments that hold the two leg bones together are stretched or torn. This injury is often misdiagnosed or goes undiagnosed because the x-ray findings are very subtle.

How are ankle sprains treated?

Initial treatment of a sprain consists of R.I.C.E therapy (rest, ice, compression, elevation). Dr. Walimire usually immobilizes the joint with a fracture boot or brace for at least two weeks, holding the foot in a neutral position. Depending on the severity, he may require you to stay off the foot during that time. After two weeks of immobilization, a patient begins physical therapy. Sprains must be properly rehabilitated to avoid chronic instability and re-injury of the ankle.

Some sprains go on to become chronically unstable. When the joint remains unstable after appropriate conservative treatment, surgical intervention is recommended. This typically involves repair of the ligaments along with ankle arthroscopy. Stabilizing the joint is of utmost importance for long term joint health to avoid arthritis.