Sprained ankles are common. It only takes an over-enthusiastic run down the stairs, or a mis-judgement of a pavement height to turn your ankle or twist your foot, after which you will likely feel a sharp pain and have to hobble home. It is important to diagnose a sprain from a fracture though and there are also some practical tips on how you can assist a quick recovery.
Signs that you have sprained your ankle
If you experience a twist or turn of your foot or ankle, it is possible that you will sprain your ankle, to one degree or another.
Symptoms of a sprained ankle include:
- Pain and tenderness
- Difficulty putting pressure or weight on that foot without pain
- Muscle spasms
Ankle sprains are generally graded according to the severity of the symptoms.
Grade 1, broadly involves
- Stretched ligaments, with minimal tearing
- Some swelling, however functionality remains and there is no instability in the joint
- Weight bearing is possible, either fully or partially
Grade 2, broadly involves
- Stretched ligaments, with partial tearing
- Moderate to severe swelling, and some loss of functionality, with mild or moderate instability in the joint
- Weight bearing is difficult
Grade 3, broadly involves
- Rupture of the ligament
- Severe swelling
- Inability to bear weight and moderate to severe joint instability
Diagnosis of an ankle sprain
It is important to ensure that your suspected ankle sprain isn’t a fracture, so diagnosis is important.
When visiting an orthopaedic specialist they may conduct one or more of the following tests, to assess your injury:
- Anterior drawer test, which assesses ankle instability
- Prone anterior drawer test, testing for ligamentous instability
- Talar tilt test, which assesses integrity of the calcaneofibular ligament
- External rotation test, which assesses the integrity of the syndesmotic ligaments
- Kleiger test, which assesses the integrity of the deltoid ligament
- Fibular compression test, which assesses syndemotic or fibular injury
- Neuromuscular evaluation of the affected limb
In addition to a thorough assessment by your doctor, radiologic studies of your ankle and foot may be required to assist with diagnosis.
These could include:
- Stress view radiography – to confirm ankle stability
- Computed tomography scanning – useful to diagnose stress fractures and osteochondritis dissecans
- Magnetic resonance imaging – useful to diagnose high ankle sprains, people with chronic pain, or injures in patients with recurring ankle sprains
- Ankle arthrography – useful in diagnosing capsular damage and further assessment of ligament damage
- Bone scanning – useful to detect stress fractures or bone abnormalities.
How you can help your ankle sprain to heal
There are a number of conservative therapy methods for ankle sprains. One of these is known as RICE:
- R – Rest
- I – Ice
- C – Compression
- E – Elevation
Another is known as PRICES:
- P – Protection
- R – Relative Rest
- I – Ice
- C – Compression
- E – Elevation
- S – Support
In many cases, once your doctor has determined that the injury is a sprain and not a fracture, you will be required to implement RICE or PRICES for a number of days, or possibly longer, whilst you recover.
Additionally, velcro braces and air splints can be used for added protection, and ankle taping may increase the stability in the ankle. Taping has a certain technique though to be effective so this is something else your doctor can help you with.
The importance of physical therapy
In order to regain a full range of movement, as well as strength in your ankle, physical therapy is important.
Certain activities to help you heal fully may include:
- Isometric exercises to help with strength building
- Use of elastic bands and surgical tubing, also to improve strength
- Proprioception rehabilitation
- Use of balance boards, or tilt boards
- Building up to jogging, sprinting and eventually to figure of eight drills, as examples
The activities may vary depending on the location, nature and severity of your sprain. Working with a specialist that can help you through the process will invariably maximise your chances of making a full recovery.
During recovery, your doctor may also prescribe some medication to ease the pain and help manage your sprain. These may include
Analgesics for pain relief
Anti-inflammatories such as ibuprofen or naproxen
Surgery for ankle sprains
- Watson-Jones procedure
- Evans procedure
- Chrisman-Snook procedure