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Ankle Sprains

Geisinger Sports Medicine - Get Back in the Game

GeisingerMechanism of Injury
An ankle sprain is a common sports injury that occurs when the ankle’s supporting ligaments are stretched beyond normal usage. Sprains often result when players misstep while running, hit an uneven surface, come down on the foot with excessive force, accidentally roll their foot, or step at an awkward inward or outward angle. The ligaments designed to protect the ankle are only capable of a certain range of motion. When the ligament is stretched abnormally, stress, or actual tearing, of the ligament fibers results.

Ankle sprains may be either inversion sprains, where the foot falls inward, overstretching the outer ligaments, or eversion sprains, where the foot is twisted outwards, overstretching the inner ligament.

A high ankle sprain results from injury to the large ligament joining the tibia and fibula, the two bones of the lower leg.

Players with an ankle sprain may experience:

  • A popping sound
  • Swelling
  • Pain
  • Instability on the ankle
  • Ankle tenderness
  • Bruising of the skin

Athletes who may have a sprain should refrain from play and visit a physician immediately.

Diagnosis & Testing
Your physician will most likely use an X-ray to diagnose an ankle sprain and rule out broken bones. Depending on the severity of the injury, there are three categories of ankle sprain:
Grade 1 – mild overstretching of the ligaments, minimal damage to ligament fibers
Grade 2 – moderate overstretching of the ligaments with partial tearing
Grade 3 – severe overstretching of the ligaments with complete tearing
Your physician will perform movement tests to help determine the grade of injury. With Grade 3, patients are usually not able to put weight on the affected ankle.
An MRI test may also be used in cases of serious ankle injury.

Treatment
In treatment of a sprain, ample time is the key to correct healing. Ankle sprains, regardless of the severity, will follow a similar path of progressive recovery. The process could take weeks or months, depending on your physician’s recommendations.

Treatment options will focus on:

  • Resting with minimal weight on ankle
  • Gradually restoration of range of motion
  • Adding strength and flexibility through exercises
  • Return to basic activities and progressive exercises
  • Eventually a return to complex movements including sharp turns and full range of motion use

Careful adherence to time restriction is important to regain full ankle stability. Failure to follow guidelines may result in chronic ankle problems including recurring ankle instability.

You may be prescribed anti-inflammatory medication to control swelling, and air splints may be used in serious cases.

Grade 3 sprains (complete tears) will not usually require surgical repair if immobilized properly. A leg cast may be used in Grade 3 treatment.

Surgical Management
Ankle sprains requiring surgery are uncommon. If a severely sprained ankle fails to strengthen and regain stability even after immobilization and progressive range of motion reintegration, surgery may be recommended.

Surgical options include:

  • Arthroscopy – use of a camera to view abnormalities in the joint area
  • Ankle reconstruction – a complete tear is repaired using suture or graft techniques

GeisingerRehabilitation
Rehabilitation is critical to obtaining positive results with ankle sprain recovery. The initial goals of rehabilitation are to reduce swelling and minimize pain, and then to reintegrate the joint and ligaments into normal movement.

Rehabilitation may include:

  • Range of motion exercises
  • Stability and weight bearing movements
  • Ankle braces to facilitate activity
  • Ultrasound/electrical stimulation
  • Resistance and weight bearing exercises
  • Endurance training
  • Water exercises
  • Agility drills
  • Prioception training (incorporating balance, coordination, agility, power, and range of motion)

The length of time it will take for an athlete with an ankle sprain to return to his or her sport of choice will be dependent upon compliance with rehabilitation and progress made. Some are back to normal within weeks, others may require a few months of therapy.

At Geisinger Sports Medicine, we help athletes with ankle sprains recover with the best techniques modern medicine has to offer. If you or your child sustains an ankle sprain, contact us today for an appointment at our state-of-the-art injury facility.

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Danville, PA 17822 MC 52-12

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Danville, PA 17822