What are ankle sprains?
Ankle sprains occur when the ligaments of the ankle are twisted or stretched beyond their normal capacity. Some cases may result in mild swelling and discomfort walking, whereas more serious cases will involve severe swelling and bruising, which can be too painful to walk on.
What causes ankle sprains?
Ankle sprains most commonly occur on the lateral (outside) aspect of the ankle as it rolls outwards whilst simultaneously the foot rolls inwards. This sudden action lengthens and stretches the ligaments, and if stretched beyond their normal limits, the sprain occurs. It is possible to sprain the medial (inside) ligaments; however these are rarer compared to lateral sprains.
Actions such as jumping, landing and twisting are typical movements that can result in a sprained ankle. Some sports that involve a lot of these types of movements include basketball, soccer and running. Other factors can include poor footwear, weakness of ankle muscles (sometimes from previous injuries), naturally lax ligaments and poor foot biomechanics.
Types of ankle sprains
There are different levels of severity when classifying ankle sprains.
Grade 1 Ankle Sprain (mild)
A grade 1 ankle sprain (mild sprain) usually involves stretching and microscopic tearing of the ligaments with mild tenderness and swelling around the ankle. They can take approximately 2-3 weeks to heal with the correct treatment.
Grade 2 Ankle Sprain (moderate)
A grade 2 (moderate) ankle sprain usually involves partial tearing of the ligament. There is moderate tenderness and swelling around the ankle with minor instability. Grade 2 ankle sprains can take approximately 4-6 weeks to heal.
Grade 3 Ankle Sprain (severe)
A grade 3 ankle sprain (severe) occurs when the ligament is completely ruptured. There is significant tenderness and swelling around the ankle with substantial ankle instability. This level of sprain may also involve a fracture on one of the ankle bones which is a more serious injury. Grade 3 ankle sprains may take approximately 8-12 weeks to heal with correct treatment and rehabilitation.
It is common to have x-ray and ultrasound imaging when a grade 2 or 3 ankle sprain is suspected to confirm the diagnosis and rule out a fracture to ensure the treatment plan is an accurate as possible.
If you have suffered from an ankle sprain, the best immediate treatment to reduce pain and swelling is RICE:
It is then essential to have it professionally assessed by a podiatrist to determine whether significant ligament or bone damage has occurred. Depending on the injury, strapping, ankle bracing or even a CAM walker (moon boot) might be required to minimise pain and further injury. After a specific diagnosis, a rehabilitation plan should be developed to restore strength and function.
Even mild ankle sprains should be assessed and treated with a thorough rehabilitation program based on stretching, strengthening and proprioception exercises. This helps treat the current injury and also helps prevent longer term issues such as ankle instability and weakness which can lead to further sprains and other injuries in future.
Can I prevent an ankle sprain?
Yes! One of the easiest ways to prevent ankle sprains is to ensure your footwear is supportive and correct for your activity. Shoes with firm heel counters help provide support around the ankle. Another easy way is to ensure your foot and ankle muscles have adequate strength, stability and flexibility (properly conditioned) for sports. Orthotics can also help reduce ankle instability and chronic ankle sprains.
If you are unsure on whether your ankles are strong enough and at risk of sprains, or you have had a history of ankle sprains, it is best to have your foot and ankle assessed by one of our Melbourne podiatrists for a comprehensive diagnosis and management plan.