Around each joint of our body are specialized structures call ligaments that stabilize the joint and inhibit excessive motion of the joint. When we have a sudden sideways motion occur in the ankle due to a twist or misstep, the force of the movement may be more than the ligaments can withstand. This can result in a sprain (partial tear) or rupture (full tear) of the ligament. These sudden injuries will cause pain at the injured ligament site from the time of injury as well as through out the healing process.
Generally pain, swelling and bruising are common for an ankle sprain. The amount of swelling and bruising can sometimes be very alarming to people. Redness and heat are also quite common at the injury site.
Touching the area or attempting to move the injured site typically will cause pain. A notable limp is expected on the injured limb.
In some ankle injury conditions the bones that make up the ankle are allowed to move in such a way that a bone deformity called talar dome injury occurs. This condition is frequently missed on initial exam (even with X-rays), and the person suffers from a long lasting pain that is described as “deep in the ankle”. Ankle pain lasting greater than 6 months post injury needs to be evaluated for this condition.
Because the symptoms for a sprained ankle are the same for a broken bone, it is impossible to determine with just simple testing weather an injury is a sprain or an actual bone fracture (brake).
Most ankle injuries will be evaluated with an X-ray to determine if there is any bone involvement. Along with the basic exam, a physician can perform simple ligament tests that help determine the level of the ankle injury. Depending on the findings of these studies will determine a persons ability to either return to activities, or possibly be immobilized.
For most ankle sprains which are mild or moderate treatment may be attempted at home using the RICE method:
Rest--- Avoid walking on the foot/ankle for a few days and limit activity to only as needed
Ice--- Apply ice to the injury for 20 minutes on and 20 minutes off. Protect the skin below the ice with a thin towel or bandage wrap.
Compression--- An elastic Ace bandage works well for this, and it helps prevent swelling. Remember, the less swelling you get initially, the faster the injury will heal.
Elevate--- Get the injured ankle elevated to around the height of your heart. If this is not practical, then elevate to your waist level.
Bad sprains require immobilization to allow the torn ligaments to repair themselves. If these ligaments remain un healed, the person will end up with a very unstable ankle that will be prone to sprains for the rest of the persons life.
Those who suffer from non-healed ankle sprains or those who have multiple sprains each year may require surgery. These procedures are designed to re-stabilize the ankle and help avoid further repetitive injuries.