Ankle Sprain/Strain

What is an Ankle Sprain/Strain? Involves an injury to the soft tissues of the ankle. Sprains involve injury to ligaments (the bands of tissue that connect bones together) within the joint and strains refer to injuries of muscles and tendons.

What causes an Ankle Sprain/Strain? Most ankle sprains and strains occur from an injury that causes the ankle to twist in an unnatural motion, stretches the tendons or ligaments, or applies a greater than normal force on the ankle joint. This can occur during participation in sports, while walking on an uneven surface or stepping or landing in a hole, or even with unexpected everyday activities in which the foot lands awkwardly. Most sprains occur when the ankle is turned inward or inverted, with the resulting injury occurring to the outside of the ankle. Ankle strains can also be the result of an overuse injury.

What are the symptoms of an Ankle Sprain/Strain? Symptoms of ankle sprains may include pain, swelling, tenderness, bruising, stiffness and decreased motion. In cases of more severe sprains, you may feel a tearing or popping of the ligaments when injury occurs. Strains cause symptoms such as pain, swelling, inflammation, muscle spasm, cramping, and loss of strength. It may be difficult to walk following a sprain or strain or you may walk with a limp.

How is an Ankle Sprain/Strain diagnosed? A physiatrist will perform a physical exam and will ask questions related to when the symptoms began, what activities caused the symptoms, what worsens or relieves symptoms, and the relative severity of symptoms. Pressure will be placed on the areas of suspected injury to identify swelling, tenderness, bruising and pain. Patients may be asked to perform certain movements to determine range of motion limitations, stability of the joint, muscle strength, and to identify what increases or decreases pain. The injured ankle and foot will also be compared to the healthy one and the area will be checked to ensure that no damage has been done to nerves or arteries. X-rays may be ordered to rule out fractures. A CT scan or magnetic resonance imaging (MRI) can provide a better view of the ligaments, tendons and muscles within the ankle or foot.

When should I seek care for an Ankle Sprain/Strain? If you injure your ankle and have pain, stiffness, swelling, muscle spasm or limited mobility that does not improve with home treatments (rest, ice, over the counter medications) after a brief period, you should seek the advice of a medical professional. If the injury or pain is severe, is accompanied by a loss of function of the joint or muscle, if the ankle is misshapen, you cannot walk on it, you have loss of feeling in the foot or lower leg, or you suspect that a bone fracture may have occurred, you should seek immediate medical attention.

What will the treatment for an Ankle Sprain/Strain consist of? Treatment for mild and moderate ankle sprains and strains (grades I and II) begins with rest, application of ice, compression, elevation, and avoidance of activities that exacerbate pain. Nonsteridal anti-inflammatory medications can be taken to reduce pain and swelling. The ankle may be immobilized temporarily with a brace, splint, bandage, or cast, and crutches may be recommended so that there is no weight placed on the injured ankle. For more moderate sprains and strains, physical therapy is recommended and may include massage, therapeutic ultrasound and heat therapy, followed by stretching, range of motion and strengthening exercises as the injury improves. More severe sprains and strains (grade III) involve a complete tearing of the ligament, tendon or muscle and may require surgery followed by a rehabilitation program to regain strength and flexibility.

Which muscle groups/joints are commonly affected by an Ankle Sprain/Strain? Ankle sprains and strains affect the ligaments, tendons and muscles in the ankle, foot and lower leg.

What type of results should I expect from the treatment of an Ankle Sprain/Strain? Most patients with mild or moderate ankle sprains and strains (grades I and II) will completely heal with conservative treatments (or no treatment other than temporary rest of the area) within a few weeks to a couple of months. For more severe injuries, surgery may be required, but is generally successful as long as the proper course of rehabilitation is followed after surgery. If injuries are not allowed to heal completely before resuming regular activities, there is a risk of re-injury. In the case of strains, a modification may need to be made in regular activities to avoid additional repetitive overuse of the area so that injury does not recur.