Ankle Sprains: Causes, Types of Severity & Its Treatment

Ankle Sprains: Causes, Types of Severity & its Treatment

Twisted Ankle, Rolled Ankle

Ankle sprains also known as a twisted ankle or rolled ankle, is a common injury amongst people of all age groups, which occurs when the strong ligaments that support the ankle stretch beyond their limits and get a tear. Depending on ligament damage, a sprain can range from mild tiny tears in fibers to severe complete tear of tissues.

If there is a complete tear of the ligaments, the ankle may become unstable after the initial injury phase passes. Repeated ankle sprains can lead to long-term problems, including chronic ankle pain, arthritis, and ongoing instability. Over time, this instability can result in damage to the bones and cartilage of the ankle joint.


It is usually caused when excessive stress is forced to ligaments as the foot is moved beyond its range, resulting in ligament strain. When this strain goes beyond their yield point, then the ligament gets sprained or damaged.

The primary cause of ankle sprain is movements of the foot especially turning and rolling of the foot. But can also occur during the normal activity of daily living like stepping off a curb or just slipping on ice.

Running on uneven surfaces, using shoes with inadequate heel support or wearing high-heeled shoes may contribute to ankle sprains. The risk is more during the activities which involve more side-to-side motion such as squash, tennis or basketball.

Before the ligaments have fully healed if a person returns to activity, ligaments may results in heal in a stretched position, leads to less stability at the ankle joint which increases the risk of ankle sprain and can also cause a condition called chronic ankle instability (CAI).


  • Swelling of the joint occurs along with pain which worsens with weight-bearing.
  • Warmth and redness are also seen as blood flow is increased.
  • Also, there is a decreased ability to move the joint.

Classification Of Severity of The Ankle Sprain

Based on severity, Ankle sprains are usually graded.

Grade I – mild stretching of the ligaments without any rupture or instability.

Grade II (moderate) – partial rupture of the ligament with moderate pain and swelling. There are limitations in functional movement and a slight to moderate instability. Generally, patients have weight-bearing problems.

Grade III (severe) – complete ligament rupture with severe pain, swelling, hematoma, and impairment of function with the instability of the ankle.


Initial treatment mainly consists of a PRICE protocol to reduce the amount of swelling and pain i.e., Protection, rest, icing, compression, and elevation.

Ankle Brace or binder is used to protect the injured ankle and to heal it as quickly and painlessly as possible.

Icing is to be frequently done to reduce edema for 10–15 minutes.

Soft tissue swelling can be prevented by compression using crepe bandage around both malleoli.

Elevation of the injured ankle by keeping a pillow under the heel is helpful

Pain-free exercises of ankle improve the mobility

Application of kinesiotape around the injured ankle prevents further damage by protecting the ligaments

Other manual techniques can be done to improve the ankle range of motion

Proprioceptive neuromuscular techniques mainly hold relax and slow reversal methods are used to strengthen the surrounding musculature.

Various proprioceptive exercises can be used to adapt the foot for walking on uneven surfaces.

Check out these links for relevant information: Pain management

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