Ankle Sprains and Orthopedic Intervention

Ankle sprain, also known as a twisted ankle, ankle injury or a rolled ankle is a condition where injury occurs to the ligaments that support the ankle joint. When one or more ligaments of the ankle are stretched too far and are either partially or completely torn, it results in an ankle sprain. A sprain normally occurs due to sudden sideways or twisting movement of the foot caused due to an awkward step or while walking on an uneven surface.

Ankle sprains most commonly occur while performing activities such as playing badminton, tennis or basketball or through daily living.1 It can also occur during daily activities such as stepping off a curb or walking on ice. Returning to routine activities before ligaments are completely healed may result in reduced stability of the ankle joint and can lead to a condition known as chronic ankle instability, which in turn increases the risk of ankle sprains.

There are two types of ankle sprains- the INVERSION ANKLE SPRAIN and the EVERSION ANKLE SPRAIN. The most common type is the inversion variant in which the foot is twisted inwards causing a stretch on the outer and lateral ligaments. About 90% of ankle sprains are inversion type. In the eversion type, the foot is twisted outwards stretching the inner ligament called the deltoid ligament.

Common symptoms following an ankle sprain are pain, swelling, tenderness, bruising, and painful restriction of movements. The severity of symptoms is directly proportional to the damage to the ligaments. On the basis of the amount of injury they are classified into grades.  

  • Grade1: Caused due to stretching of ligament; symptoms include pain and swelling but patients can walk with pain.
  • Grade2: Grade 2 involves partial tearing of a ligament. The patient experiences pain along with swelling and bruising and he can just take a few steps but can’t walk.
  • Grade3: Grade 3 involves complete tearing of a ligament with severe pain, swelling and bruising and patients can’t walk at all; he or she needs to use crutches.

Treatment includes ‘R.I.C.E’ measures2- Rest to the affected ankle, an Ice application reduces pain and swelling, Compression by applying a crepe bandage around the joint provides support to the ligaments and Elevation helps reduce the swelling. Along with this, NSAIDs (pain killers) can be taken to control pain and reduce inflammation. This initial treatment can be followed by physiotherapy which helps in strengthening surrounding muscles and ligaments, thus speeding recovery and reducing recurrence. Surgical intervention may be required in severe cases. If you suspect you have a more serious ankle sprain, please contact us for professional diagnostics and care.

Penned by Dr. Rachita Narsaria, MD

1. Waterman, B. R., Owens, B. D., Davey, S., Zacchilli, M. A., & Belmont, P. J. (2010). The epidemiology of ankle sprains in the united states. The Journal of Bone and Joint Surgery, 92(13), 2279-2284.

2. http://www.aafp.org/afp/2001/0101/p93.html