Ankle Sprains (Part I of III)

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What is an ankle sprain?

An ankle sprain is an injury to the ligamentous structures supporting the ankle.  There are 3 basic types of ankle sprains – lateral, medial and high, with lateral ankle sprains being the most common.

The classic lateral ankle sprain is when the ankle is twisted in such a way the foot turns inward (inversion injury) damaging one of the 3 lateral (outside) ligaments.  The pain and swelling is on the lateral side of the ankle.

A medial ankle sprain occurs when the ankle is twisted in such a way that the foot turns outward (eversion injury) damaging the single medial ligament called the deltoid ligament.  The pain and swelling with this injury if on the medial side of the ankle.

The high (aka syndesmotic) ankle sprain occurs when the ankle is everted and externally rotated usually with a traumatic force placed on the outside of the ankle.  With this injury, pain and swelling are usually diffuse with a moderate amount of swelling in the front of the ankle.  These take the longest to recover from.

What should I do for an ankle sprain?

It all depends on the type of injury sustained and ligaments damaged.  For any type, the RICE principle is always a good place to start.  RICE starts for REST, ICE, COMPRESSION and ELEVATION, but I add an extra R to the mix – REHABILITATION.  I believe active rehabilitation, which includes proprioceptive (balance) training for ankle sprains are key to future function prevention of future injury.

For lateral ankle sprains, a compressive wrap or lace-up ankle brace can be helpful.  However, medial and high ankle sprains may need additional support in the form of a walking boot and potentially crutches.  There will be additional blog posts specifically discussing the different brace/stabilizer options and common rehab principles for ankle sprains.

When should I see a doctor?

Evaluation in the clinic involves ruling out fractures and evaluating stability of the ankle joint itself.  If you are having difficulty bearing weight on that ankle immediately or having significant pain and swelling, then seeing us at Advanced Orthopaedic Specialists can get you back on the road to recovery.

Written by, Dr. Ramon Ylanan

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