An ankle sprain is an injury to one or more ligaments in the ankle, usually on the outside of the ankle. More specifically, the ankle sprain is an injury to the lateral ligamentous complex, comprised of the anterior talofibular ligament and the calcaneofibular ligament. These are the ligaments that support the ankle. Ligaments are bands of tissue (like rubber bands) that connect one bone to another and bind the joints together. In the ankle joint, ligaments provide stability by limiting side-to-side movement.
Some ankle sprains are much worse than others. The severity of an ankle sprain depends on whether the ligament is stretched, partially torn, completely torn, or involves a number of ligaments. Ankle sprains are not the same as strains, which affect muscles rather than ligaments.
Ankle sprains are graded based on severity, from I to III:
Treatment for an ankle sprain depends on the grade of the sprain and the number of ankle sprains the patient has experienced prior to the injury.
A sprained ankle often result from a fall, a sudden twist, or a blow that forces the ankle joint out of its normal position. An ankle sprain commonly occurs while participating in sports, wearing inappropriate shoes, or walking or running on an uneven surface.
Sometimes an ankle sprain occurs because a person is born with weak ankles. Previous ankle or foot injuries can also weaken the ankle and lead to sprains.
Pain is the first sign of an ankle sprain. Other symptoms may include soreness, swelling, bruising, tenderness, difficulty walking, or stiffness in the joint. If a ligament has completely torn, you may have felt a “pop” when the injury occurred.
These symptoms may vary in intensity, depending on the severity of the sprain. Sometimes pain and swelling are absent in people who have had previous ankle sprains. Instead, they may simply feel the ankle is wobbly and unsteady when they walk. Even if there is no pain or swelling with a sprained ankle, treatment is crucial. Any ankle sprain–whether it is your first or your fifth–requires prompt medical attention.
There are four key reasons why an ankle sprain should be evaluated promptly by a foot and ankle surgeon like Dr. Neitzel:
A physical examination is needed to determine the severity of the sprain and what treatment is needed.
During your examination, Dr. Neitzel will gently press around the ankle to determine which ligaments are injured. She will also move your ankle in different directions, testing your range of motion. Of course, a stiff, swollen ankle usually will not move much, but Dr. Neitzel will be able to tell the severity of your ankle sprain based upon the amount of swelling, pain, and bruising you may have.
There are both nonsurgical and surgical treatment options available to treat ankle sprains.
When you have an ankle sprain, rehabilitation is crucial and it starts the moment your treatment begins. Dr. Neitzel may recommend one or more of the following nonsurgical treatment options:
Full recovery times can range from a few weeks to a few months, depending on the severity of the sprain.
The majority of ankle sprains resolve uneventfully with conservative treatment. However, a small percentage of patients may have chronic ankle instability if the ligament heals in a stretched position and is unable to hold the ankle in place properly. Recurrent ankle instability is linked to the development of post-traumatic ankle arthritis in the future, so surgical intervention is generally recommended to correct this problem. An MRI is typically performed before surgery to confirm damage to the tissues in the ankle.
During surgery, Dr. Neitzel evaluates the ankle and may remove damaged tissue. The ligaments may also be reconstructed with a suture anchor augmentation device–a procedure that enables patients to return to work and play more quickly and with better results.
After surgery, rehabilitation is extremely important. Completing your rehabilitation program is crucial to a successful outcome. Be sure to schedule follow-up appointments with Dr. Neitzel during this period to ensure that your ankle heals properly and function is restored.
If you have sprained your ankle, please call Peninsula Podiatry at (360) 309-0804 to schedule an appointment with Dr. Neitzel for evaluation and treatment.
