Ankle sprains are very common injuries. There’s a good chance that while playing as a child or stepping on an uneven surface as an adult you sprained your ankle–some 25,000 people do it every day.
Sometimes, it is an awkward moment when you lose your balance, but the pain quickly fades away and you go on your way. But the sprain could be more severe; your ankle might swell and it might hurt too much to stand on it. If it’s a severe sprain, you might have felt a “pop” when the injury happened.
A sprained ankle means one or more ligaments on the outer side of your ankle were stretched or torn. If a sprain is not treated properly, you could have long-term problems. Typically the ankle is rolled either inward (inversion sprain) or outward (eversion sprain). Inversion sprains cause pain along the outer side of the ankle and are the most common type. Pain along the inner side of the ankle may represent a more serious injury to the tendons or to the ligaments that support the arch and should always be evaluated by a doctor.
You’re most likely to sprain your ankle when you have your toes on the ground and heel up (plantar flexion). This position puts your ankle’s ligaments under tension, making them vulnerable. A sudden force like landing on an uneven surface may turn your ankle inward (inversion). When this happens, one, two or three of your ligaments may be hurt.
A sprain can be difficult to differentiate from a fracture (broken bone) without an x-ray. If you are unable to bear weight after this type of injury, or if there is significant swelling or deformity, you should seek medical treatment from a doctor (MD or DO). This may be your primary care physician or pediatrician, an emergency department, or an orthopaedist, depending on the severity of the injury.
Treating your Sprained Ankle
Treating your sprained ankle properly may prevent chronic pain and instability. For a Grade I sprain, follow the R.I.C.E. guidelines:
Rest your ankle by not walking on it. Limit weight bearing. Use crutches if necessary; if there is no fracture you are safe to put some weight on the leg. An ankle brace often helps control swelling and adds stability while the ligaments are healing.
Ice it to keep down the swelling. Don’t put ice directly on the skin (use a thin piece of cloth such as a pillow case between the ice bag and the skin) and don’t ice more than 20 minutes at a time to avoid frost bite.
Compression can help control swelling as well as immobilize and support your injury.
Elevate the foot by reclining and propping it up above the waist or heart as needed.
Swelling usually goes down with a few days.
For a Grade II sprain, follow the R.I.C.E. guidelines and allow more time for healing. A doctor may immobilize or splint your sprained ankle.
A Grade III sprain puts you at risk for permanent ankle instability. Rarely, surgery may be needed to repair the damage, especially in competitive athletes. For severe ankle sprains, your doctor may also consider treating you with a short leg cast for two to three weeks or a walking boot. People who sprain their ankle repeatedly may also need surgical repair to tighten their ligaments.