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Ankle Sprain

Condition: Ankle sprains involve the stretching or tearing of the ligaments that hold together the ankle joint and can be classified as either mild, moderate, or severe.

Background: The most common ankle sprains are lateral ligament sprains (85% of all sprains) and occur from rolling of the foot and rotation of the lower leg. As the foot rotates, the 3 main ligaments supporting the ankle tear in succession, depending upon the severity of the sprain.

Risk Factors: Lateral ankle sprains occur most commonly in athletics, comprising 2-25% of all sports injuries. Up to 40% of ankle sprains become a long-term problem.

History and Symptoms: Following injury, swelling and bruising are observed. Pain, which is often worse with weight bearing; altered walking; and decreased range of motion are reported. Mild sprains typically heal within 12 days, moderate sprains heal within 2 weeks, and severe sprains heal after 4.5-26 weeks. Symptoms may worsen before starting to improve. Swelling may take months to completely resolve, and decreased range of motion and weakness may persist.

Physical Exam: Physical examination may reveal altered walking, tenderness near the injured ligaments, and swelling. Stability of the ligaments should be assessed, and a full assessment of movement should be performed in both the affected and unaffected ankles.

Diagnostic Process: X-rays, ultrasound, or magnetic resonance imaging (MRI) may be used to rule out fractures or to determine the severity of the sprain.

Rehab Management: Most ankle sprains warrant “PRICE” therapy, consisting of protection, relative rest, ice, compression, and elevation to reduce swelling, minimize pain, and restore range of motion. More conservative approaches may utilize a walking boot and rest in early care. Rehabilitation is intended to optimize function and strengthen the ankle, using appropriate exercises. Pain can be relieved with oral or topical medications and by reducing swelling. Using ankle supports, such as elastic bandages or tape, encourages a faster return to sports and work compared to complete immobilization of the ankle.

Other Resources for Patients and Families: Physicians work with patients and coaches or employers as well as with athletic trainers, physical therapists, and orthotists. Patients should be taught appropriate home exercises and balance training, and athletes should receive a sport-specific program.

 

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