Ankle Sprains

An ankle sprain is an injury to the lateral ligamentous complex, comprised of the anterior talofibular ligament and the calcaneofibular ligament. These are the ligaments that support the ankle. Ankle sprains are among the most common injuries to the lower extremities, with approximately 25,000 ankle sprains occurring in the U.S. on a daily basis.

Ankle sprains are graded based on severity, from I to III:

  • Grade I sprains – The anterior talofibular ligament is stretched, and there may be microscopic tearing of the ligament fibers.
  • Grade II sprains – The anterior talofibular ligament is completely torn.
  • Grade III sprains – Both the anterior talofibular ligament and the calcaneofibular ligament are completely torn.

Treatment for an ankle sprain depends on the grade of the sprain and the number of ankle sprains the patient has experienced prior to the injury.

At FORM Ortho, our orthopedic surgeons treat a high volume of ankle sprains on a monthly basis. If you have sprained your ankle, we are happy to help you get back on your feet as quickly and safely as possible.

What causes an ankle sprain?

Ankle sprains typically happen when the ankle is suddenly twisted or rolled. This can occur during sports activity, or while walking or exercising on an uneven surface, or from falling or tripping.

What are the symptoms of an ankle sprain?

Pain is the first sign of an ankle sprain. Other symptoms may include swelling, bruising, and tenderness. If a ligament has completely torn, you may have felt a “pop” when the injury occurred.

The ankle may also be unstable, and you may be unable to walk on it. When the ankle is unstable, it is easy for it to shift and roll out of place. This can cause recurrent instability, which can lead to cartilage damage or an ankle fracture. In these cases, you should seek medical treatment as soon as possible.

How is an ankle sprain diagnosed?

A physical examination is needed to determine the severity of the sprain and what treatment is needed. 

During your examination, your foot doctor will gently press around the ankle to determine which ligaments are injured. He will also move your ankle in different directions, testing your range of motion. Of course, a stiff, swollen ankle usually will not move much, but your foot doctor will be able to tell the severity of your ankle sprain based upon the amount of swelling, pain, and bruising you may have.

Imaging Tests

Your foot doctor may order X-rays to rule out a broken bone, as a broken bone can cause similar symptoms of pain and swelling. Other imaging tests that may be ordered include:

Stress X-rays – scans are taken while the ankle is being pushed in different directions, giving your foot doctor an idea of whether the ankle is moving abnormally because of injured ligaments.

Magnetic Resonance Imaging (MRI) – an MRI may be ordered if your foot doctor suspects you have a severe injury to the ligaments, damage to the cartilage or bone of the joint surface, a small bone chip, or another problem. 

Ultrasound – this imaging scan allows your foot doctor to observe the ligament directly while he moves your ankle, giving him an idea of how much stability the ligament provides.

What is the treatment for an ankle sprain?

Initial treatment of an ankle sprain involves a cast or a Cam boot to immobilize the ankle. After approximately 2 weeks, the patient will switch to an ankle-stabilizing orthosis.

The mainstays of treatment for an ankle sprain are rest, ice, elevation, and stabilization. Anti-inflammatory medications may be helpful for reducing pain and swelling. Physical therapy, which is offered on-site at FORM Ortho, is also an important part of recovering from an ankle sprain. Physical therapy focuses on strengthening the ankle and on proprioception to improve stability and correct imbalance. This is necessary for a true rehabilitation of an ankle sprain.

Full recovery times can range from a few weeks to a few months, depending on the severity of the sprain.

Chronic Ankle Instability

The majority of ankle sprains resolve uneventfully with conservative treatment. However, a small percentage of patients may have chronic ankle instability if the ligament heals in a stretched position and is unable to hold the ankle in place properly. Recurrent ankle instability is linked to the development of post-traumatic ankle arthritis in the future, so surgical intervention is generally recommended to correct this problem. An MRI is typically performed before surgery to confirm damage to the tissues in the ankle.

Surgical Treatment

Surgery for recurrent ankle instability usually involves arthroscopy, a procedure in which a small camera called an arthroscope is inserted into the ankle via a small incision. The arthroscope displays images from inside the ankle on a monitor in the operating room, allowing your orthopedic surgeon to perform the surgery through small incisions.

During the procedure, your orthopedic surgeon will evaluate the ankle and may remove damaged tissue. The ligaments may also be reconstructed with a suture anchor augmentation, such as the Arthrex InternalBrace™ device. The InternalBrace™ is used because it allows patients to return to work and play more quickly and with better results.

Sprained Ankle Treatment in Fremont, California

At FORM Ortho, our orthopedic surgeons treat a full range of foot and ankle problems, including ankle sprains. We also offer physical therapy on-site to help you get back on your feet as soon as possible. If you would like to schedule an appointment, please contact our office.