What are ankle sprains, and how do you treat them?

An ankle sprain is a common injury that occurs when the ligaments supporting the ankle joint are stretched or torn - in fact, they occur in 85% of ankle injuries. This can happen when the ankle is twisted, turned, or rolled beyond its normal range of motion, often during physical activities or accidents. Ankle sprains can vary in severity - mild sprains tend to be easily manageable at home, but more severe sprains may require professional help.

Grading ankle sprains

The ankle joint is stabilised by several ligaments, including the anterior talofibular ligament (ATFL), the calcaneofibular ligament (CFL), and the posterior talofibular ligament (PTFL). When you sprain your ankle by twisting or rolling it, it means that the motion has led to these ligaments becoming overstretched or torn. The severity of the sprain is classified into three grades:

- Grade 1 (Mild): This involves stretching and minor tearing of the ligament fibres. Symptoms include mild pain, swelling, and tenderness around the ankle. The joint remains stable, and the individual can usually bear weight on the affected foot with minimal discomfort.

- Grade 2 (Moderate): This grade involves a partial tear of ligaments. Symptoms include moderate pain, swelling, bruising, and some loss of function. The ankle likely feels unstable, with the affected foot less able to bear weight, and doing so very painfully.

- Grade 3 (Severe): This involves complete tearing of ligaments. Symptoms include severe pain, significant swelling, bruising, and instability of the ankle joint. The individual is unable to bear weight on the affected foot due to both instability and extreme pain.

Treatment of ankle sprains

The treatment for an ankle sprain depends on the severity of the injury. The primary goals are to reduce pain and swelling, promote healing, and restore function. The following steps, known as the RICE method (for obvious reasons), are commonly recommended:

1. Rest: Avoid activities that put stress on the ankle. Resting the ankle helps to prevent further injury and allows the healing process to begin.

2. Ice: Apply ice packs to the injured area for 15-20 minutes every 2-3 hours during the first 48 hours. This helps to reduce swelling and numb the pain.

3. Compression: Use an elastic bandage to wrap the ankle, providing support and reducing swelling. Be careful not to wrap it too tightly, as this can impede blood flow.

4. Elevation: Keep the injured ankle elevated above the level of the heart as much as possible. This helps to reduce swelling by allowing fluids to drain away from the injured area.

For the more common lower gradings of ankle sprain, the RICE method and careful management of the ankle at home can lead to a very simple full recovery over the course of a few weeks. However, if improvements come slow or not at all over time, it is likely that you have a higher severity of injury that may require medical intervention. This can include physical therapy to restore strength and flexibility, and in rare cases, surgery to repair torn ligaments. Contact a medical professional such as a GP or orthopaedist if you suspect you have a severe sprain after marginal improvements from the RICE methods.

Risk factors for ankle sprains

Several factors can increase the risk of sustaining an ankle sprain:

- Previous Injuries: A history of ankle sprains can weaken the ligaments and make the ankle more susceptible to future injuries.

- Sports Participation: Engaging in sports that involve jumping, cutting actions, or rapid changes in direction, such as football or basketball can increase the chance of a sprain.

- Uneven Surfaces: Walking or running on uneven surfaces can lead to accidental twists and turns of the ankle.

- Improper Footwear: Wearing shoes that do not provide adequate support or fit properly can increase the risk of ankle sprains.

- Poor Physical Condition: Lack of strength, flexibility, and coordination can make the ankle more prone to injury.

- Age and Sex: Females tend to be at higher risk of ankle sprains and other lower body injuries due to biological differences in hip structure.

Dr. Francesc Malagelada is a leading consultant trauma and orthopaedic surgeon based in London. He treats foot and ankle disorders, using non-surgical and surgical treatments that best suit each patient and their lifestyle.

When appropriate, he performs arthroscopy (keyhole) or minimally-invasive surgery using the latest techniques. Some benefits of these are that they can provide faster recovery and almost unnoticeable scars. Dr Malagelada’s research into the field of minimally-invasive surgery resulted in a PhD with a ‘cum laude’ distinction.

Should you suspect you have any of these conditions, or have general foot and ankle pain, then click here to request an appointment now.