A sprained ankle, 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 tear. They range from mild to severe; depending upon how much damage there is to the ligaments. Sprains can range from tiny tears in the fibers that make up the ligament to complete tears through the tissue.
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.
Ankle sprains are caused usually through excessive stress on the ligaments of the ankle. When the foot is moved past its range of motion, the excess stress puts a strain on the ligaments. If the strain is great enough to the ligaments past the yield point, then the ligament becomes damaged, or sprained.
Movements – especially turning and rolling of the foot – are the primary cause of an ankle sprain.
The risk of a sprain is greatest during activities that involve explosive side-to-side motion, such as squash, tennis, or basketball.
They can also occur during normal daily activities such as stepping off a curb or slipping on ice.
Running on uneven surfaces, using shoes with inadequate heel support andwearing high-heeled shoesmay contribute to ankle sprains
Returning to activity before the ligaments have fully healed may cause them to heal in a stretched position, resulting in less stability at the ankle joint. This can lead to a condition known as chronic ankle instability (CAI), and an increased risk of ankle sprains.
Signs and symptoms
Inflammationoccurs due to migration of WBCs resulting in swelling of the joint 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
Ankle ligament sprains are usually graded on the basis of severity.
Grade I is a mild stretching of the ligaments without macroscopic rupture or joint instability.
Grade II (moderate) is a partial rupture of the ligament with moderate pain and swelling. There are functional limitations and a slight to moderate instability. Typically, patients present with problems in weight bearing.
Grade III (severe) is a complete ligament rupture with marked pain, swelling, hematoma and pain. In grade III injuries, there is a marked impairment of function with instability.
Initial treatment commonly consists of PRICE i.e., Protection, rest, icing, compression and elevation. RICE helps limit the amount of swelling to the area.
Ice is often used to reduce swelling in cycles of 15–20 minutes on and 20–30 minutes off.In uncomplicated lateral ankle sprains, swelling of the soft tissue can be prevented with compression around both malleoli,elevation of the injured ankle higher than the heart, and pain-free exercises.
Compression bandages are used to provide support and compression for sprained ankles. Braces and crutches are also used to help alleviate the pain so the injured ankle can heal as quickly and painlessly as possible.