Foot sprain: what it is, how to intervene

By Cristiano Antonino On Apr 18, 2023

Foot or ankle sprain is one of the most common injuries among sportsmen

A sprain is a trauma involving the capsule and ligaments of a joint and in this case the most damaged ligament is the collateral one.

Although breaking the foot or ankle only occurs in a minority of sprain cases, it is very important not to underestimate this trauma and to take the necessary precautions both to prevent it and also to treat it.

In fact, it is not only athletes who are subject to foot sprain, but it can also occur in the case of simple daily gestures such as getting out of bed, climbing stairs, walking on uneven ground, or even when you put your foot down to stop the bike .

The ankles are subjected to numerous stresses every day which can also turn into trauma if the foot is positioned incorrectly, or is loaded with excessive weight.

Foot sprain: what is it?

To understand how to prevent a sprained foot or how to treat it, it is essential to know what it is.

A sprain affects the capsule and ligaments of a joint, and in the case of an ankle sprain it is the collateral ligament. But when does a distortion occur?

When the ankle is forced to make a sudden and abrupt movement that goes beyond the physiological limits of movement, and is caused by a lever or a twist.

The joint and, therefore, the ankle perform an unnatural movement which generates the loss of contact between the joint heads, with the possible laceration of the ligaments.

What are the causes that can lead to a distortion?

The causes that lead to foot sprain are numerous and, although the incidence is higher among sportsmen, there are many other situations in which this trauma can occur.

The movement that generates the distortion with the greatest incidence is certainly the “retort”.

It is in fact an abrupt and sudden movement that generates the inversion of the joint combined with a flexion of the sole of the foot.

This happens more frequently during sports practice, when the foot is subjected to numerous stresses and sudden movements, but not only.

Here are what other dangerous situations can be:

when walking on uneven ground which can be dirt or asphalt but with irregularities;
when the bike, scooter, kick scooter or skateboard stops and the foot is not placed correctly, loading it with weight;
when you go up or down the stairs and even in this case you do not place your foot on the surface in the correct way;
using unsuitable footwear and in particular high heels;
in the presence of muscle imbalances;
joint changes;
situations of obesity or overweight.

Among the sports more predisposed to this type of trauma are volleyball, basketball, football, rugby and running.

We now come to the most common symptoms concerning a foot sprain

In this case the symptomatology is clear and easily identifiable.

First of all, a sharp pain is detected at the site affected by the trauma and this pain increases when the weight is shifted on the ankle.

There may also be swelling in the affected area, in some cases bruising and bruising may appear.

In general there is a limitation of movement.

In some rarer cases there may also be joint effusions.

Diagnosis and treatment

The diagnosis of foot sprain takes place through specific instrumental tests.

First of all, it is essential to carry out a correct diagnosis of the state of the ankle, in order to be able to intervene and thus avoid a worsening of the situation or further sprains in the following months.

As soon as the foot has suffered the trauma, the first thing to do is an objective evaluation by a doctor or orthopedist.

In fact, instrumental imaging tests cannot return a precise image of the situation when the ankle is in a state of severe inflammation and swelling.

The advice is therefore to undergo further tests 4-5 days after the trauma.

The first examination to be carried out is the X-ray, which can be done immediately after the trauma if there is a suspicion of a fracture, otherwise it is advisable to wait a few days.

Another useful test for diagnosis is magnetic resonance which, however, can only be performed starting 10-15 days after the trauma.

MRI is useful in cases where the need for surgery is assumed.

The doctor will therefore first do an objective examination in which he will evaluate:

the dynamics of the accident;
ankle mobility;
the appearance and level of pain;
the patient’s medical history.

If you do not have the opportunity to take an X-ray, the doctor will be able to avoid the hypothesis of a fracture by relying on the Ottawa criteria which state that:

if you feel pain on palpation of the malleolus, metatarsal or navicular bone, it is likely that there is a fracture;
if the patient cannot independently do 4 steps, it is likely that there is a fracture.

To identify bone lesions, therefore, the most precise diagnostic test is x-ray, while to identify soft tissue lesions, the doctor may prescribe an ultrasound or an MRI at a later time.

Foot sprain needs to be treated immediately, even before the doctor can make the diagnosis.

The more timely you are, the greater the chances of reducing the pain and inflammation.

In this case, therefore, the first treatment to be done is absolute rest: the patient who has suffered this trauma must rest and avoid putting body weight on the ankle.

Then ice should be applied immediately and the limb elevated.

Cryotherapy should be applied throughout the day for cycles of 15-20 minutes with intervals of 30-60 minutes.

At the same time, the limb should be bandaged tightly and lifted.

It is very important to bandage correctly: in fact, the foot must be tight but not excessively so as to allow normal blood circulation.

If it is a non-slight distortion, it is advisable to accompany this therapy with the intake of non-steroidal anti-inflammatory drugs: these can be taken orally or applied topically in the form of a gel.

These treatments, if applied immediately after the trauma and for the following 4-5 days, can lead to a full functional recovery of the ankle, if the trauma has obviously not caused fractures or soft tissue injuries of a certain relevance.

Prevention and rehabilitation in case of foot sprain

When the trauma is moderate or severe, full functional recovery cannot be restored only with cryogenic therapy, bandaging and the use of anti-inflammatories.

In this case it is necessary to follow a specific rehabilitation therapy which can last from a minimum of 2-3 weeks up to several months, depending on the seriousness of the situation.

The therapy must obviously be conducted by a physiotherapist, who will be able to carry out a specific program of exercises aimed at improving joint mobility.

One of the most widespread therapies is the one based on proprioceptive exercises with workouts that improve balance and mobility, correcting foot support.

Along with therapies in the gym, it is good practice to continue with mobility exercises independently, on a daily basis, such as walking for 30 minutes a day following correct posture.

If physical therapies are required, however, specialists can prescribe treatments with:

ultrasound
laser
iontophoresis
TENS therapy

Although there are no specific prevention systems, there are some good habits to follow that help the body avoid or mitigate this distorting trauma.

Among these are certainly:

the use of suitable, comfortable footwear that facilitates walking;
always warm up before exercising and with correct joint mobility;
maintain a good weight in order to avoid any possible stress on the ankles;
avoid too intense workouts and in general, respect the recovery times of your body;
use a brace or specific footwear to protect against sudden movements and ankle strain.

In any case, the advice is to immediately contact a specialist who will be able to advise you on the most correct therapies, rehabilitation and prevention practices for your case.

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