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An ankle sprain is an injury to the ligaments that hold together the bones above and below the ankle joint. The main ligaments impacted are just below the bone bumps on the inner and outer side of the ankle. Although the injury can occur to both the inner and outer ligaments, it is more common that the injury happens to the outer ligaments.
Ankle sprains happen when the foot is rolled out of its normal position, for example during a fall or landing awkwardly after a jump.
Fractures and cartilage damage can occur with these injuries, so X-rays and other imaging studies are important. Without proper immediate care, the injury will not heal properly risking future ankle sprains. This condition is associated with other foot/ankle conditions such as arthritis and unstable ankles.
The decision between surgical and conservative treatment is ultimately dependent on the patient. Factors to be considered include the type of injury, the severity of the injury, the lifestyle and age of the patient, and their medical history.
Oral anti-inflammatory medication can help reduce symptoms and swelling that comes after the ankle sprain takes place.
Physical therapy with insulated cold packs applied on and off of the sprain site for the first 72 hours helps to reduce swelling and discomfort. Alternating application of warmth and coolness in 15 to 20 minute intervals help to resolve the swelling after 72 hours after the injury.
Applying a cast around the joint to maintain the proper position for 3 to 4 weeks is very important so that the ligaments do not heal in a loose position. The cast can be applied in one piece, or as a removable model with Velcro straps.
The ankle joint can become tight during the casting period. Physical therapy is an important first step once the cast comes off to regain proper motion in the joint. A lace up leather ankle brace is recommended during this transition period for the next 2 to 4 weeks. Strengthening the muscle tendons around the inner and outer ankle helps to secure the joint in place. Most importantly, exercises that restore balance are the best way to prevent future sprains once the injured ligaments are in the last stages of proper healing.
Pain in the ankle joint is most effectively resolved by medicinal injections that stop the pain and inflammation of the irritated or damaged cushion lining inside the joint.
This procedure is the gold standard for diagnosing problems within the ankle joint.
Ankle arthroscopy is a minimally invasive surgical procedure that allows a small camera to go into the ankle through two small 1 cm incisions to the front of the ankle.
Any damage to the ankle joint cartilage and inner joint wall lining is cleaned up and removed. Partial weight bearing in a removable cast is allowed after suture removal at 14 days, full weight bearing at 3-4 weeks.
Ankle Stabilization is used to fix the weak or loose ankle ligaments impacted by the ankle sprain.
The incision is 2 to 3 cm in length on the outer part of the foot near the ankle. The ligaments are repaired (sometimes by adding a ligament graft) with strong sutures.
Non-weight bearing in a cast or cast boot for 3 to 4 weeks after the surgery. Full weight bearing in a cast boot 4-6 weeks with physical therapy and light exercise at 6 to 8 weeks.
A lower-grade ankle sprain can heal in 3 weeks with or without an ankle brace. A higher-grade sprain with ligament or joint damage can take 4 to 6 weeks to heal using a walking cast or CAM walker cast boot.
The way in which you may injure or fall to create an ankle sprain is part of the diagnosis. Signs and symptoms include pain, swelling, bruising, and inability to bear weight. An examination by a physician would include an x-ray to rule out other injuries as well as techniques like the “anterior drawer sign” that indicates one or two possible ligaments were torn.
Certain ankle sprains can heal on their own, but some untreated ankle sprains can cause future joint damage, arthritis, or additional ankle sprains from the instability.
The fastest way to heal an ankle sprain is to avoid bearing weight for 1 to 3 weeks and immobilize the ankle in a CAM walker or walking cast.
A typical examination for an ankle sprain includes the palpation of structures like ligaments, tendons and joints that are commonly injured during this injury. X-rays are common as well as more advanced testing like a MRI.
Most ankle sprains do require a walking boot to keep them in the correct position during the healing process and to prevent reinjury.
Normal swelling can subside in 72 hours, but a sprained ankle can remain swollen for up to 6 to 8 weeks. Elevation, ice, and support stockings will help with swelling during the healing process.
“I have never been to any kind of doctor that has been as thorough and seemed to truly care about my well being. My injury was 6 months ago and Dr. Moore has seen me at a minimum of every 3 weeks to check on it and find different ways to relieve my pain and try to help me gain my mobility back. This is a workman’s comp case that has been a heck of a struggle for me and Dr. Moore and his staff have been so helpful in pushing to help me get approval for everything I may need. Sam is so kind and genuine, she is always gentle and caring when she is taking care of me. I would 100% recommend Dr. Moore and his team to anybody.”
-Rachael
If you’ve sprained your ankle and are seeking evaluation as well as a variety of treatment options, we can help. Contact Moore Ankle and Foot Specialists today!
Our doctors have extended specialist medical training focused on the foot, ankle and lower leg. We are board-certified surgeons and experts in delivering care for complex foot and ankle disorders as well as cosmetic or reconstructive procedures and problems related to sports injuries and other medical conditions.
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