Ankle sprains 101 – Q&A
What is an ankle sprain?
An ankle sprain refers to stretching or tearing of the ligaments of the ankle. The most common ankle sprain occurs on the outer part of the ankle.
What part of the ankle get damaged the most?
There are multiple ligaments in the ankle. The two most commonly injured are:
- The ATFL or anterior talofibular ligament, which connects the talus to the fibula on the outside of the ankle.
- The CFL or calcaneal fibular ligament, which connects the fibula to the calcaneus below.
What are the grades of Ankle Sprains?
A Grade 1 Sprain (Mild)
- Slight stretching and microscopic tearing of the ligament fibres
- Mild tenderness and swelling around the ankle
A Grade 2 Sprain (Moderate)
- Partial tearing of the ligament
- Moderate tenderness and swelling around the ankle
- There is an abnormal looseness of the ankle joint when the ankle is moved in a certain direction
A Grade 3 Sprain (Severe)
- Complete tear of the ligament
- Significant tenderness and swelling around the ankle
- Substantial ankle instability when the ankle is pushed or pulled in a certain direction
What are the symptoms an ankle sprain?
- Pain on the inner or outer part of the ankle joint
- Loss of range of movement
- Limping gait
- Tenderness over inner or outer part of ankle joint
How is an ankle sprain diagnosed?
Ankle sprains can be diagnosed fairly easily through physical examination. The location of pain on the ankle with tenderness and swelling in a patient who rolled their ankle is very suggestive.
What are treatment options?
Almost all ankle sprains can be treated without surgery. Even a complete ligament tear can heal without surgical repair if it is immobilised appropriately.
A three-phase program guides treatment for all ankle sprains—from mild to severe:
- Phase 1 – includes progressive loading, resting, protecting the ankle and reducing the swelling.
- Phase 2 – includes restoring range of motion, strength and flexibility.
- Phase 3 – includes balance exercises and the gradual return to activities that do not require turning or twisting the ankle.
Rehabilitation exercises that are used to prevent stiffness, increase ankle strength and prevent chronic ankle problems include:
- Early motion
- Strengthening exercises
- Proprioception (balance) training
- Endurance and agility exercises
How long is recovery?
Recovery may take just 2 weeks to complete for minor sprains, or up to 6 to 12 weeks for more severe injuries.
I have sprained my ankle many times. Should I be concerned?
Yes. The more you sprain an ankle, the greater the chance that problems will develop. For example, turning the ankle can lead to damage to the cartilage inside the ankle joint and your balance may be compromised.