Ankle sprains are on the most common injuries of the foot. They can happen at any time to anyone from athletes to adults and children. A sprain can occur when you are participating in a sport or physical activity, or even if you step on an uneven surface, or step down on an awkward angle.
An ankle sprain can be very painful and uncomfortable. I have sprained my ankle on numerous occasions from various sports injuries to stepping on an uneven surface. Luckily for me, all my sprains were minor and required conservative treatment that I could do at home along with some physiotherapy.
The ankle has many ligaments that help hold the bones and joints in position. They are in place to help prevent the ankle from any abnormal positions like twisting or rolling of the foot. Ligaments are like an elastic band; they can stretch within their limits then go back to their original shape. Once the ligament is stretched beyond its means, a sprain can occur. The most severe sprain occurs once the ligament(s) has torn. This brings us to the different types of ankle sprains that can occur.
The two main types of ankle sprains are eversion and inversion sprains. An eversion sprain is more rare and occurs when the ankle rolls too far inwards. This can be accompanied by a fracture of the fibula. The deltoid ligament is one of the strongest ligaments of the ankle making it harder to sprain. That’s why this type of sprain is often rare and is usually a result of a break or fracture of the fibula.
The most common type of ankle sprain is an inversion sprain. This occurs when the ankle rolls too far outwards injuring the ligaments on the outside of the ankle. The two main ligaments that can be injured here are the ATFL (anterior talofibular ligament) and the CFL (calcaneal fibular ligament).
Once you get an ankle sprain it is important to get it checked to make sure it’s not too serious. Once you visit your doctor or foot specialist, there are a few tests that can be done to determine the degree of injury. An x-ray is sometimes done to determine if there is a break or fracture of the bone. There are three grades of a sprain. Grade 1 is a mild sprain, grade 2 is a moderate sprain, and grade 3 is a severe sprain that usually involves a break.
For grade 1 and 2 sprains the practitioner will probably notice tenderness and swelling at the site of injury. This is usually accompanied by bruising. You may also have limited range of motion of the ankle and should not try to force it in any one position. With a grade 1 or 2 sprain there will be a microscopic tear to partial tears of the fibers of the ligaments. With a grade 3 sprain you will most likely have a complete tear or rupture of the ligament.
There are a number of treatment options available for each type of sprain. Here are a few for each grade of sprain:
Grade 1 Sprain
- RICE (Rest, Ice, Compression, Elevation). Make sure you rest and only weight bear as tolerated. Ice the area daily until the swelling comes down. You can use a tensor band to aid with compression and lastly elevate the ankle to help reduce swelling and inflammation.
- Full range of motion stretching and strengthening exercises as tolerated.
- Do not immobilize the foot by casting or splinting, as this won’t allow for any stretching exercises.
Grade 2 Sprains
- Immobilize foot with an air cast or splint to prevent further injury of the ligaments.
- Physical therapy with stretching and icing exercises as well as strengthening exercises.
Grade 3 Sprains
- Immobilization of the foot.
- Physical therapy similar to a grade 2 sprain but for a longer period of time.
- Surgical intervention if necessary.
Ankle sprains can happen at any given moment so it is always important to be aware of your surroundings and to wear proper footwear to help stabilize and support the foot. If you do sprain your ankle it is very important to get it checked out to determine the extent of the sprain and the appropriate treatment option necessary.
For more information, or to book an assessment, please contact Ontario Foot and Orthotics at one of our two locations: 519-623-3000 (Cambridge), 905-878-6479 (Milton). Or visit us online at www.ontariofoot.ca.