Ankle Sprain

Inability to move ankle without significant painInability to put any weight on that footPain over a bony part of your foot or anklePain that interferes significantly with walkingPain not relieved by ice, pain relief medication, and elevationNumbness in the leg, foot, or anklePain that does not improve in 5-7 daysUncertainty about the severity of the injuryUncertainty about how to care for this injury The doctor will: Ask you about your symptoms and how the injury occurredExamine your ankle to assess the severity of the injury Tests may include: X-rays to make sure that no bones are broken MRI scan to see if a ligament has torn completely (rarely needed) Ankle sprains are graded according to the damage to the ligaments. The more ligaments involved, the more severe the injury. Grade 1Some minor tearing of ligament tissue, but the ankle remains stable Grade 2Partial tearing of ligament tissueMild instability of the jointUsually involves damage to two ankle ligaments Grade 3Complete tearing of two or three of the ligamentsSignificant instability of the joint Treatment Treatment for a sprained ankle includes: RestAvoid putting any pressure on your ankle by not walking on it. Using crutches will allow for partial weight-bearing. This is allowed, early on, except in three ligament tears.IceApply ice or a cold pack to the ankle for 15-20 minutes, 4 times a day for at least 2-3 days. This helps reduce pain and swelling. Wrap the ice or cold pack in a towel. Do not apply the ice directly to your skin.CompressionWrap your ankle in an elastic compression bandage (eg, Ace bandage). Wrap from the toes going up toward the knee. This will limit swelling of your ankle and foot.ElevationKeep your ankle raised above the level of your heart as much as you can for 48 hours. This will help drain fluid and reduce swelling. MedicationTake one of the following drugs to help reduce inflammation and pain: Ibuprofen (Motrin, Advil)Naproxen (Aleve, Naprosyn)Acetaminophen (Tylenol)AspirinRehabilitation exercisesBegin exercises to restore flexibility, range of motion, and strength of the muscles around your ankle as recommended by your health care professional.BraceYou may need to wear a brace to immobilize your ankle. In many instances, a brace, which stabilizes and compresses the ankle, will allow for early weight bearing and an earlier return to activity. You will be rehabilitating the ankle as it heals. If you play sports, you may need to wear an ankle brace or tape your ankle when you return to play.Leg castA cast is very rarely needed for an ankle sprain. If you have a severe sprain, your doctor may recommend a short leg cast for 2-3 weeks, but this is very rare. In many cases, there are special braces that can be used instead of a cast.SurgerySurgery is rarely needed to repair an ankle sprain, but it may be necessary to repair a third degree sprain in which all three ligaments are torn. Prevention Many ankle sprains cannot be prevented. However, you can reduce your risk of spraining an ankle:

Take a break from sports or exercise when you feel tired.Do exercises that strengthen leg and foot muscles.Learn the proper technique for exercise and sporting activities. This will decrease stress on all your muscles, ligaments and tendons, including those around your ankle.If you have injured your ankle before, you are much more likely to injure it again. You may reduce your risk of repeated sprains by wearing an Air-Cast or other ankle brace. RESOURCES: American Academy of Orthopaedic Surgeonshttp://www.aaos.org American Orthopaedic Society for Sports Medicinehttp://www.sportsmed.org CANADIAN RESOURCES: Canadian Orthopaedic Associationhttp://www.coa-aco.org/ Canadian Orthopaedic Foundationhttp://www.canorth.org/ References: American Academy of Orthopaedic Surgeons website. Available at: http://www.aaos.org . American Orthopaedic Society for Sports Medicine website. Available at: http://www.sportsmed.org . Ankle sprain. eMedicine Consumer Journal . 2001 Jan 13. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/ . Sports Injuries: Basic Principles of Prevention and Care . Blackwell Scientific Publications; 1993.

Last reviewed March 2008 by Robert E. Leach, MDPlease be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.