Ankle sprain: definition, symptoms and treatment

By Cristiano Antonino On Apr 10, 2023

One misstep is enough to end up with a sprained ankle! In fact, it is one of the most common musculoskeletal injuries in every age group and affects both athletes and extremely sedentary people

The pain that is felt during the injury is caused by the stretching or – in the most serious cases – by the rupture of the ligaments of the joint, while the consequences are swelling and difficulty walking.

Although it is not a particularly serious pathology, it is advisable that, in the case of persistent pain or swelling, the doctor is contacted.

In fact, without proper treatment and rehabilitation, a severely sprained ankle may not heal well and lose its mobility and stability, resulting in recurring sprains and longer recovery times in the future.

What is meant by sprained ankle?

A sprained ankle is an injury that occurs when you twist or turn your ankle in an unnatural way.

In fact, these movements are able to hyperextend or tear the bands of tissue (i.e. the ligaments) that have the function of keeping the ankle bones together and in line.

The function of the ligaments is to stabilize the joints, preventing excessive movements: when these are forced beyond their normal range of motion we will have a distortion of the joint.

Typically, ankle sprains usually affect the ligaments on the outside of the joint.

Ankle sprain anatomy

The most common type of ankle sprain is an inversion injury or lateral ankle sprain.

The foot rolls inward, injuring the outer ankle ligaments: the anterior talofibular ligament, the calcanofibular ligament, and the posterior talofibular ligament.

Less common are sprains that affect the ligaments of the inner ankle (medial ankle sprains) and syndesmotic sprains, which involve the tibiofibular ligaments, the ligaments that join the two leg bones (the tibia and fibula) just above the ankle.

Syndesmotic sprains, which occur most often in contact sports, can cause chronic ankle instability and subsequent sprains.

Causes and risk factors

As we have seen, a sprain occurs when the ankle is forced out of its normal position, which can cause one or more ligaments in the ankle to stretch, partially tear, or completely tear.

Causes of a sprained ankle could include:

A fall that twists the ankle.
Landing awkwardly on foot after jumping or spinning.
Walking or exercising on an uneven surface.
Another person stepping or landing on your foot during a sporting activity.
Obviously, there are some risk factors that greatly increase the chance of an ankle sprain, and they are:
Sport activity. Ankle sprains are a common sports injury, particularly in sports that require a jumping, cutting, or rolling or twisting action of the foot such as basketball, tennis, soccer, football.
Irregular surfaces. Walking or running on uneven surfaces or poor field conditions can increase your risk of sprained ankle.
Previous ankle injury. Once you sprain your ankle or suffer another type of ankle injury, you are more at risk for re-injury.
Bad physical condition. Poor ankle strength or flexibility can increase the risk of sprains while playing sports.
Improper shoes. Shoes that don’t fit properly or aren’t suited to an activity, as well as high-heeled shoes in general, make your ankles more vulnerable to injury.

Degrees of severity of ankle sprain, symptoms and recovery times

The severity of an ankle sprain depends on how much damage the incorrect movement causes and how unstable the joint becomes as a result.

The more severe the sprain, the longer the recovery.

We can classify ankle sprains into three large groups, depending on the severity of the injury:

Grade 1: in this case the stretching of the tendon-ligament structures is minimal and there is no tear. Symptoms are mild, such as mild pain and mild swelling. There is usually no bruising, joint instability, or difficulty bearing weight. Recovery time varies from 1 to 3 weeks.
Grade 2: This type of injury is more serious than the first, we see a partial laceration of the ligament structures. The complained symptoms are pain, swelling, possible presence of bruises. Additionally, there is mild joint instability, loss of motion and function. If we load the joint with the weight of the body we will have pain. It will take 3 to 6 weeks to get back to normal.
Grade 3: it is the most serious type of ankle sprain, because there is a major laceration of the affected ligament or its complete rupture. The symptoms are severe pain, swelling, presence of bruises, due to the formation of subcutaneous hematomas. Joint instability is considerable and there will certainly be loss of function and freedom of movement. In this case you will not be able to bear the pain even by performing simple actions such as walking. It will take several months to heal.

How to treat sprained ankle

If you sprain your ankle, you will need to intervene immediately after the injury.

The first goal is to reduce pain and swelling and protect the ligaments from further injury.

This usually means taking a few simple measures: rest, ice, sling compression, and keeping the affected limb elevated.

If you experience severe pain and swelling, rest your ankle as much as possible for the first 24 to 48 hours.

During this time, you can soak the foot and ankle in cold water or apply an ice pack (be sure to cover the ankle with a towel to protect the skin) for 15-20 minutes to deflate the limb and reduce pain. minutes three to five times a day or until swelling subsides.

To help reduce swelling, it is good to compress the ankle with an elastic band or ankle brace.

When sitting, it is recommended to lift the ankle up to hip height if possible.

In the first 24 hours, avoid anything that could increase swelling, such as hot showers, hot packs, or rubs.

Nonsteroidal anti-inflammatory drugs such as ibuprofen can help reduce pain and swelling and may also speed recovery.

Functional treatment of ankle sprain

To fully recover from an ankle sprain, you need to restore the ankle joint’s normal range of motion and strengthen its supporting ligaments and muscles.

It may be necessary to consult a physical therapist who will guide us towards the right path of recovery.

Studies have shown that recovery to normal activities is faster when treatment is based on restoring ankle function – often with the help of splints, splints, tapes or elastic bandages – rather than immobilization (such as the use of a plaster cast).

Called functional treatment, this strategy usually involves three phases: Ice, rest, and foot lift in the first 24 to 48 hours to reduce pain, swelling, and the risk of further injury; range of motion and strengthening exercises within 48-72 hours; and training or physical therapy to improve stamina and balance once recovery is well underway.

Exercises for mobility and stretching should be continued until the pain is completely gone, starting with exercises sitting or lying down when the pain is severe, to performing exercises standing, with the load of the body weight.

When to seek medical attention

Unless your symptoms are mild or improve soon after the injury, your best bet is to contact your doctor.

You may request a meeting right away if the pain and swelling are severe or if your ankle is numb or unable to bear weight.

During your visit, your doctor will examine your ankle and foot and may manipulate them in various ways to determine the type of sprain and the extent of the injury.

This exam may be delayed for a few days until the swelling and pain improve; in the meantime you can continue to apply ice, keep the ankle at rest and elevated.

For a diagnostic confirmation, the doctor may request some instrumental tests, such as an X-ray of the affected site.

X-rays, however, are not routinely used to evaluate ankle injuries, as in most cases the source of the problem is the ligaments, which cannot be seen with this imaging technique, so an ultrasound or scan may be needed. MRI.

In any case, the doctor will suggest the best diagnostic imaging for the individual situation.

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