An ankle sprain refers to the tearing of ankle ligaments, most commonly occurring on the lateral (outside) part of the ankle. It's a prevalent injury, with approximately 25,000 cases daily, often due to sports or uneven surfaces. Although it can coincide with an ankle fracture, it typically happens independently.
Symptoms
Patients usually experience pain after twisting their ankles, often due to inward rolling of the foot (inversion injury), common in sports and daily activities like stair-walking. Following a sprain, pain, swelling, and bruising on the outside of the ankle are common, accompanied by varying degrees of weight-bearing difficulty.
Although it's a common belief that being able to walk on an ankle means it's not broken, this isn't always accurate.
Causes
Ankle sprains result from the ankle twisting underneath the leg, known as inversion, common in activities like basketball and soccer. Individuals with high-arched feet or a history of severe sprains are more prone. Weak muscles, especially the peroneals supporting the ankle's outside, increase susceptibility.
Anatomy
Multiple ligaments are involved in ankle sprains, notably the anterior talofibular ligament (ATFL) and the calcaneal fibular ligament (CFL). Differentiating these from high ankle sprains, which affect ligaments connecting the tibia to the fibula, is crucial.
Diagnosis
Physical exams and X-rays usually diagnose ankle sprains, evident through pain, swelling, and inversion-type injury. However, it's vital not to overlook other injuries like torn peroneal tendons or fractures in adjacent bones. MRI may be necessary for severe cases.
Treatments
Surgery is rarely required for ankle sprains; most heal with appropriate care. Treatment varies based on severity, with grades ranging from mild (Grade 1) to severe (Grade 3). Rest, ice, compression, and elevation (R.I.C.E.) are standard for Grade 1 sprains. Grade 2 and 3 may require immobilization, with severe cases needing surgery for chronic ankle instability.
Recovery
The recovery process typically consists of three phases:
- Restoration Phase: Involves resting, protecting, and reducing swelling in the injured ankle.
- Rehabilitation Phase: Focuses on restoring the ankle's flexibility, range of motion, and strength.
- Return to Activity Phase: Gradually reintroduces straight-ahead activity, followed by sport-specific exercises such as sprinting and cutting.
Once you regain the ability to bear weight on your ankle, Dr. Kamel will recommend exercise routines to enhance muscle and ligament strength, improve flexibility, balance, and coordination. As you progress, activities like walking, jogging, and running figure-eights can be performed with ankle support, either through taping or wearing a supportive brace.
Completing the full rehabilitation program is crucial to minimize the risk of recurring ankle injuries. Failure to complete rehabilitation or improper healing of ligaments may lead to chronic pain, instability, or even arthritis in the ankle. Persistent ankle pain could indicate inadequate healing of the ligaments or additional injuries like cartilage damage or peroneal tendon injuries.
To prevent future ankle sprains, it's important to heed warning signs of pain or fatigue, and maintain good muscle balance, flexibility, and overall strength through regular exercise.
Concerns
High ankle sprains are less common but often more severe. Most ankle sprains don't require surgery, but repeated sprains can lead to long-term issues like cartilage damage. If recurrent sprains occur, getting a consultation is advisable.
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