Types Of Ankle Ligament Injuries
Just like any injury, injuries to the ankle ligaments are graded based on severity.
In Grade 1: ankle ligaments are stretched but still intact.
In Grade 2: the ligaments are partially torn
In Grade 3: The ligaments are completed torn and the two ends are pulled apart like a rubber band that snapped.
Common Ankle Injuries: How To Treat A Sprained Ankle
Around the house, on the playing field, or somewhere in between, many of us will suffer a sprained ankle or two in our lifetime. In fact, its been estimated that approximately 28,000 Americans sprain an ankle each day. Interestingly enough, while ankle sprains represent nearly 10 percent of all emergency room visits, roughly 68 percent of people who suffer from them do not seek professional medical treatment. Many individuals are used to simply walking it off and may potentially return to play well before the injury has fully healed. This is truly unfortunate, because an ankle sprain may weaken the surrounding tissues, leading to ankle instability and increasing the chances of the injury occurring again in the future. A single severe sprain or a history of ankle sprains may set the stage for other conditions, including osteoarthritis, later in life. Of course, not all ankle sprains will require professional treatment, and there are many at-home remedies suitable for treating mild sprains. However, if a chronic condition does develop, it may require conservative care therapies or other treatments. At Sports Medicine Oregon, we specialize in a range of sprained ankle treatments and preventative care options, to keep athletes and other active individuals on the move.
How Do Doctors Treat Ankle Sprains
Mild ankle sprains dont need special treatment. In the first 24 hours after a sprain, doctors have you do a treatment called PRICE, which stands for:
Protect your ankle with a bandage or splint
Rest your ankle by not walking on it and using a crutch
Ice your ankle with an ice pack wrapped in a towel
Compress your ankle with an elastic bandage to keep it from swelling
Elevate your ankle as high as your heart, or higher, to keep it from swelling
To lessen pain, you can take acetaminophen or a nonsteroidal anti-inflammatory drug such as ibuprofen.
Your ankle could heal within a few days. Your doctor will recommend walking and doing other activities only if you wear shoes that support your ankle and are careful not to put too much weight on your injured foot. As your ankle sprain heals, you’ll slowly be able to walk more and do other activities.
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Medicines For A Sprained Ankle
You can take certain over-the-counter painkillers such as paracetamol or ibuprofen to help ease your ankle pain. You can get ibuprofen gels and creams that you apply to the skin over your ankle you may find these helpful.
If over-the-counter painkillers dont help, your doctor may offer you a prescription for stronger pain relief. Always read the patient information that comes with your medicine. If you have questions, ask your pharmacist or doctor for advice.
How To Treat Sprains And Strains Yourself
For the first couple of days, follow the 4 steps known as RICE therapy to help bring down swelling and support the injury:
To help prevent swelling, try to avoid heat , alcohol and massages for the first couple of days.
When you can move the injured area without pain stopping you, try to keep moving it so the joint or muscle does not become stiff.
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More About Your Injury
There are 3 grades of ankle sprains:
- Grade I sprains: Your ligaments are stretched. It is a mild injury that can improve with some light stretching.
- Grade II sprains: Your ligaments are partially torn. You may need to wear a splint or a cast.
- Grade III sprains: Your ligaments are fully torn. You may need surgery for this severe injury.
The last 2 kinds of sprains are often associated with tearing of small blood vessels. This allows blood to leak into tissues and cause black and blue color in the area. The blood may not appear for several days. Most of the time, it is absorbed from the tissues within 2 weeks.
If your sprain is more severe:
- You may feel strong pain and have a lot of swelling.
- You may not be able to walk, or walking may be painful.
Some ankle sprains may become chronic . If this happens to you, your ankle may continue to be:
- Painful and swollen
- Weak or giving way easily
Ligaments: Holding The Ankle Together
Your ankle has several ligaments. Sometimes more than one is sprained. With a bad sprain, you may also have a broken bone in your ankle.
Usually happen when you twist your foot
Can be mild, moderate, or severe depending on whether the ligament is stretched, partly torn, or fully torn
Cause pain and swelling
Don’t show up on x-rays, but doctors may do x-rays to look for a nearby broken bone
Are treated by Protecting the area, Rest, Ice, Compression, and Elevation
Sometimes require a splint or cast
Usually heal on their own
May require surgery if the ligament is completely torn
See a doctor if you’re unable to stand or walk.
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What Can I Expect If I Have A Sprained Ankle
After giving your ankle time to heal and treating the sprain according to your healthcare providers recommendations, you’ll be able to get back to regular activities. Your prognosis depends on your commitment to building strength back in your ankle through exercises and rehabilitation. If your ankle hasn’t healed completely or you stopped the strengthening exercises, your injured ligament could weaken and put you at risk for future ankle sprains.
Immobilize A Severe Sprain
If you have a more severe sprain that involves tearing, your doctor may do more to immobilize your ankle. That may involve splints, boots, or casts depending on the severity. This isnt a common sprained ankle treatment, but it may be necessary for a severe tear or an injury that isnt healing well on its own.
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What Are The Types Of Ankle Sprains
There are three types of ankle sprains based on how much ligament damage occurred:
- Grade 1 . The ligament fibers stretched slightly or there is a very small tear. Your ankle will have minor swelling and tenderness to the touch.
- Grade 2 . The ligament is torn, but it isnt a complete tear. Your ankle has swelling over the injury and it hurts to move.
- Grade 3 . The ligament is torn completely. Your ankle has significant swelling, the injury is painful and walking is difficult.
Reducing Swelling And Pain
Your initial treatment goal is to get the pain and swelling under control. Both symptoms usually happen immediately after the injury and can last several days.
Ankle swelling is one of the first things youll deal with after a sprain. It usually starts going down after about 48 hours, but you can do some things to reduce the swelling faster.
The common recommendation for reducing swelling and treating a sprained ankle is the RICE treatment. That stands for rest, ice, compress, and elevate.
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When To Call The Doctor
You should call your provider if you notice any of the following:
- You cannot walk, or walking is very painful.
- The pain does not get better after ice, rest, and pain medicine.
- Your ankle does not feel any better after 5 to 7 days.
- Your ankle continues to feel weak or gives away easily.
- Your ankle is increasingly discolored , or it becomes numb or tingly.
Physical Therapy Sprained Ankle Exercises
Physical therapy is a popular rehabilitation treatment for severe ankle sprains, and it can also help prevent re-injury for those struggling with ankle instability and chronic ankle sprains. Physical therapy for ankle sprains focuses on strengthening the muscles of the foot, as well as targeting connective tissues to increase flexibility and range of motion. A physical therapist will create a personalized exercise regimen based on the injury and physiology of the patient. During the initial stages of treatment, the physical therapist will demonstrate how to properly perform these exercises. However, once the individual is comfortable, these exercises can be performed from the convenience and comfort of home. Physical therapy exercises should be performed daily for optimal results.
Whether you are struggling with ankle instability as a result of chronic ankle sprains, or have a child who has just suffered his or her first ankle sprain, there are many treatment options that can restore stability and prevent future sprains in the years ahead. At Sports Medicine Oregon, we offer a wide range of conservative care treatments, as well as surgical options when appropriate, to help athletes and active individuals achieve their activity and stability goals. Dont let ankle instability hold you back. Take the next step and minimize your risk of injury-related osteoarthritis today!
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What Is A High Ankle Sprain
A high ankle sprain is a sprain in the upper ligaments of your ankle, above the ankle itself. These ligaments are attached to the fibula and the tibia, stabilizing the entire area for activities like running and walking.
When you damage or tear those ligaments often due to rotating or twisting your ankle youre experiencing a high ankle sprain. This type of sprain doesnt occur as often as a sprain in the lower part of the ankle.
When To Get Help For A Sprained Ankle
Someone with a sprained ankle should go to the ER right away if it any of the following occurs:
- The joint appears deformed
- The injured person is pale or has an unsteady pulse
- The injured person experiences paralysis, tingling, or extreme pain
You may also need to see your doctor or a specialized sports medicine doctor if you have a severe sprain and/or your symptoms persist despite practicing R.I.C.E. at home.
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Treating Your Sprained Ankle
Treating your sprained ankle properly may prevent chronic pain and looseness. For a Grade 1 sprain, follow the R.I.C.E. guidelines:
Rest your ankle by not walking on it. Limit weight bearing and use crutches if necessary. If there is no broken bone you are safe to put some weight on the leg. An ankle brace often helps control swelling and adds stability while the ligaments are healing.
Ice it to keep down the swelling. Don’t put ice directly on the skin and don’t ice more than 20 minutes at a time to avoid frostbite.
Compression can help control swelling as well as immobilize and support your injury.
Elevate the foot by reclining and propping it up above the waist or heart as needed.
Swelling usually goes down in a few days.
For a Grade 2 sprain, follow the R.I.C.E. guidelines and allow more time for healing. A doctor may immobilize or splint your sprained ankle.
A Grade 3 sprain puts you at risk for permanent ankle looseness . On rare occasions, surgery may be needed to repair the damage, especially in competitive athletes. For severe ankle sprains, your doctor may also consider treating you with a short leg cast for 2-3 weeks or a walking boot. People who sprain their ankle repeatedly may also need surgical repair to tighten their ligaments.
Return To Activities After Ankle Sprain
It is often thought that ankle sprain is a harmless injury, but we have previously seen that it can be the cause of subsequent pathologies such as osteoarthritis or chronic ankle instability.
Some protocols and standardizations for Return To Sport have been used for situations such as post- LCA operation or hamstring injury, but still remains unknown to many subjects. Evidence-based medicine is missing, particularly related to foot injuries and ankle, to assist in the decision to allow an athlete to RTS. Thanks to a recent systematic review by Tessigol et al. we know that there are currently no published evidence-based criteria to inform RTS decisions for patients with an LAS injury.
Even if the literature doesn’t help us have the usual bases on a return to sport after ankle sprain, it doesn’t mean that athletes are not to be tested.
Managing ankle sprains in primary care: what is best practice? A systematic review of the last 10 years of evidence
Richard Seah 1, Sivanadian Mani-Babu
PMID: 20710025 DOI: 10.1093/bmb/ldq028
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Return To Full Activities
Steve Debenport/Getty Images
While there is no clear consensus, most healthcare providers agree that you can resume full activities once the risk of re-injuring your ankle falls to what it was before you got hurt.
In general, you shouldn’t try to return to your normal sports routine until you’ve reached the following goals:
- No more swelling
- Normal joint motion
- Normal joint strength
A team trainer or healthcare provider should ensure that you’re ready to return to sports before you start playing again.
How To Treat A Sprained Ankle: A Step
Think only athletes suffer from sprained ankles? This very common injury can happen to anyone, whether youre running a marathon or suffer a slip and fall accident thats why learning how to treat a sprained ankle is important.
Since many people treat minor sprains at home, its tough to say how many sprains happen, but theyre the most common musculoskeletal injury primary care providers treat. Every day, more than 23,000 people get medical treatment for sprains. At sports medicine clinics, sprained ankles make up about 30% of injuries treated. A sprained ankle is also a common workplace injury covered by the workers compensation insurance.
Even though its a very common injury, it isnt always minor or easy to treat. The injury can be very painful and sometimes lasts several weeks. You may need medical interventions from your doctor if the sprain is severe.
Knowing how to treat a sprained ankle is important in shortening your recovery time and ensuring you get the medical care you need. It can help ease the pain faster and prevent something more severe from happening.
Follow these guidelines for sprained ankle treatment to get back on the mend faster.
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High Ankle Sprain Diagnosis
When you meet with your medical provider, theyâll gather information about your medical history and have you explain how you injured your ankle. After this, theyâll conduct a physical examination to determine the primary location of your pain. A physical exam may include:
- An external rotation test: During the external rotation test, youâll sit with your knee bent at a 90-degree angle. Your doctor will gently twist your foot to the outside and note the intensity and location of your pain.
- A squeeze test: During the squeeze test, your doctor will squeeze your tibia and fibula together to put pressure on the interosseous membrane. Pain from this test usually indicates a high ankle sprain.
For confirmation or to check the severity of your injury, your doctor may order an imaging test.
MRI. The most useful test for a high ankle sprain is a magnetic resonance imaging test, or an MRI. An MRI uses a large magnet and computer-generated radio waves to create images of tissues inside the body.
X-rays.X-rays use waves of radiation to produce images. Materials that are dense, like bone, donât absorb as much radiation as less-tense materials, like organs, and this allows bones to show up white on an X-ray. Your doctor can use an X-ray to check that the bones are still in place after your ligament injury. They may also use an X-ray to make sure that none of your ankle bones are damaged.
Treatment Of High Ankle Sprain
High ankle sprains heal slowly recovery time may be longer than more common sprains.
Most doctors recommend R.I.C.E. as an immediate course of treatment if there are no broken bones. This stands for:
- Rest: Doctors recommend not walking or putting any weight on the ankle. Depending on the severity of the injury, doctors may suggest wearing an ankle brace to keep the bones stable and allow the ligaments to heal.
- Ice: Applying ice to the ankle can help reduce any swelling. Put the ice in a pillowcase or wrap it in a thin towel to protect the skin. Apply ice for around 20 minutes at a time.
- Compression: Wrapping the injured ankle in bandages can also reduce swelling.
- Elevation: Lifting the leg above the heart while sitting down may also help.
If a person has a severe injury, they may need to wear a cast to allow the ligaments to heal. If the persons tibia and fibular have separated or if they have broken any bones, they may need surgery using plates and screws to repair the damage and reconstruct the ligaments.
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Range Of Motion Exercises
For the most part, ankle sprains don’t need to be immobilized with a cast or boot to prevent movement. In fact, simple exercises are an important part of treatment.
The first step toward recovery is to regain the ability to move your ankle normally. Pain and swelling can both limit movement, so address those first. Check with your healthcare provider to determine when it’s okay to start range-of-motion activities.
Physical therapists often recommend tracing the alphabet in space with your big toe. Start with print letters, then try cursive. This simple activity will move your foot through all the basic ankle motions.