What is a Sprained Ankle?
An ankle sprain is a partial or complete tear of one or more ligaments of the ankle. A ligament is a strong band of tissue that connects one bone to another. Ankle sprains typically involve the lateral (outside) ligaments when someone “rolls” the ankle and the foot turns inwards. Less commonly rolling the foot outwards can lead to a “high ankle sprain” or syndesmosis injury with can be a more serious condition.
What are the Symptoms?
When a ligament is torn bleeding occurs at the site of the tear. In the acute phase the ankle becomes painful and swollen. Bruising may become apparent. The severity of the symptoms varies depending on the degree of the tear. A severe sprain may make weight bearing difficult or impossible due to pain in the early stages.
The vast majority of ankle sprains recover including those with complete tears. A small percentage of people experience ongoing pain or instability (giving way) and require assessment by an orthopaedic surgeon.
What is the Treatment?
An acute sprain requires R.I.C.E. (rest, ice, compression and elevation). If your ankle is so painful you cannot walk on it you should see your doctor who can order an x-ray to ensure you have not broken it. A brief period of immobilisation in a CAM boot may allow you to walk, with or without crutches, until the pain subsides. Early mobilisation is generally recommended to speed up your recovery. A physiotherapist will progress your exercises for movement, strength, proprioception (balance), and endurance.
If after a number of months you are not progressing and you have ongoing pain or instability, you can be referred to an orthopaedic surgeon for assessment. Conditions which may cause ongoing pain include osteochondral lesions, peroneal tendon tears, small fractures of the ankle or heel bone, and soft tissue impingement. Chronic laxity of the sprained ligaments may lead to instability causing your ankle to give way repeatedly. Osteochondral lesions, soft tissue impingement, and some small fractures can be treated with ankle arthroscopy. Peroneal tendon repair is an open procedure to repair tears of these tendons. Chronic instability requires ankle ligament reconstruction.