Ankle Sprain

A broken or sprained ankle is one of the most common injuries among all age groups.  An ankle break is commonly caused by twisting/rotating your ankle, rolling the ankle, tripping/falling, or impact from a car accident causing one or more of the ankle bones to chip, crack, or break. The classification of the break is determined by the area that is broken, ranging from simple breaks to more complex. A more severe break will cause the ankle to become more unstable. Symptoms may include immediate and severe pain, bruising, tenderness, inability to bear weight on the injured foot, and/or deformity (bone is out of place).

A sprain, on the other hand, is when the ligaments (fibrous tissue holding the ankle joint in position) become disrupted or torn. The most common causes of an ankle sprain include exercising on an uneven surface or playing a sport that requires cutting, rolling, and/or twisting action of the foot (running, basketball, tennis, football, soccer, etc.). Sometimes with a sprain you can hear or feel a “pop”, which is the ligament tearing. Sprains are classified by three grades which indicate how much damage has been done.

Grade 1 Sprain (Mild)

• Slight stretching or tearing of ligament(s)
• Mild tenderness/swelling

Grade 2 Sprain (Moderate)

• Partial tear of ligament
• Moderate tenderness/swelling
• On medical exam, the joint is abnormally loose

Grade 3 Sprain (Severe)

• Complete tear
• A lot of tenderness/swelling
• Substantial instability

For a grade 1, and some grade 2 sprains, a good first step is home treatment of R.I.C.E., which stands for Rest, Ice, Compression and Elevation.  In addition, it is important to schedule an appointment with a medical professional as soon as possible.  Through Direct Access, you may not need a physician’s referral to schedule an appointment directly with a certified physical therapist.  This often provides quicker access to care and therefore a faster recovery.

An evaluation by a physical therapist can help identify the type and severity of an ankle sprain by performing specific tests, palpation of the affected area, and identifying areas of laxity or weakness.  A therapist will also screen for more serious causes of pain and swelling (such as a fracture) and refer the patient to the appropriate physician should additional testing or imaging be required. Seeing a physical therapist can help speed the recovery of an ankle sprain which is typically 2-8 weeks depending on severity of the sprain.  A physical therapist will not only restore range of motion, flexibility and strength, but also improve balance, as well as provide instruction about how to safely return to a specific sport, occupation or hobby. While ankle sprains usually recover quickly, it is important to ensure full strengthening of the area and restored balance through a comprehensive physical therapy program, as recurrent ankle sprains and chronic instability have been reported in as many as 80% of cases.

Commitment to a home exercise plan following PT is a key to maintaining good muscle strength, balance and flexibility, which will help prevent re-injury and chronic problems.  And don’t forget…once you have put the time and effort into your recovery, follow these precautions to prevent future injury:

• Warm up thoroughly before exercise or physical activity.
• Pay attention when walking/running/working on uneven surfaces.
• Wear proper footwear.
• Slow down or stop when you feel pain or fatigue.