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  • Ankle Sprains

    Ankle Sprains

    An ankle sprain occurs when the strong ligaments that support the ankle stretch beyond their limits and tear. Ankle sprains are common injuries that occur among people of all ages. They range from mild to severe, depending upon how much damage there is to the ligaments.  Ligaments are strong, fibrous tissues that connect bones to other bones. The ligaments in the ankle help to keep the bones in proper position and stabilize the joint.

    Most sprains are minor injuries that heal with rest, ice, compression, and elevation (RICE). However, if your ankle is very swollen and painful to walk on or if you are having trouble weight bearing, be sure to see your doctor and physical therapist.  Without proper treatment and rehabilitation, a more severe sprain can weaken your ankle, making it more likely to re-injure. Repeated ankle sprains can lead to long-term problems, including chronic ankle pain, arthritis, and ongoing instability.

    Most sprained ankles occur in the lateral ligaments on the outside of the ankle. Sprains can range from tiny tears in the fibers that make up the ligament to complete tears through the tissue.  If there is a complete tear of the ligaments, the ankle may become unstable after the initial injury phase passes. Over time, this instability can result in damage to the bones and cartilage of the ankle joint.


    • Walking or exercising on an uneven surface
    • Falling down
    • Participating in sports that require cutting actions or rolling and twisting of the foot—such as trail running, basketball, tennis, football, and soccer
    • During sports activities, someone else may step on your foot while you are running, causing your foot to twist or roll to the side.


    • Swelling
    • Bruising
    • Tenderness to touch
    • Instability of the ankle—this may occur when there has been complete tearing of the ligament or a complete dislocation of the ankle joint.

    If there is severe tearing of the ligaments, you might also hear or feel a “pop” when the sprain occurs.

    Grades of Ankle Sprains

    After the examination, your doctor will determine the grade of your sprain to help develop a treatment plan.

    Grade 1 Sprain (Mild)

    • Slight stretching and microscopic tearing of the ligament fibers
    • Mild tenderness and swelling around the ankle

    Grade 2 Sprain (Moderate)

    • Partial tearing of the ligament
    • Moderate tenderness and swelling around the ankle
    • Abnormal looseness of the ankle joint, when tested by a doctor or physical therapist

    Grade 3 Sprain (Severe)

    • Complete tear of the ligament
    • Significant tenderness and swelling around the ankle
    • Substantial instability occurs when a doctor or physical therapist moves the ankle


    Home Treatments

    For milder sprains, your doctor may recommend simple home treatment.

    Follow the RICE protocol as soon as possible after your injury:

    • Rest your ankle by not walking on it.
    • Ice should be immediately applied to keep the swelling down. 20 minutes on, 20 minutes off as much as possible
    • Compression dressings, bandages or ace-wraps will immobilize and support your injured ankle.
    • Elevate your ankle above the level of your heart as often as possible during the first 48 hours.

    Medication. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen can help control pain and swelling. Because they improve function by both reducing swelling and controlling pain, they are a better option for mild sprains than narcotic pain medicines.

    Physical therapy. Rehabilitation exercises are used to prevent stiffness, increase strength, increase proprioception, and prevent chronic ankle problems.