What Is a Sprained Ankle?
A sprained ankle is a common injury that occurs when your ankle ligaments(tissues that support ankle bones) get torn or overstretch when you roll, twist, or fall.
Many people fail to report acute ankle sprains and this results in significant underestimated data by the emergency department. According to the National Library of Medicine research, one estimate indicated that the actual incidence rate of acute ankle sprains in the general population of the Netherlands was 5.5 times higher than the rates reported in emergency department data. This difference suggested an incidence rate of 19.0 to 26.6 per 1,000 person-years, as observed in a survey that included, both treated and untreated ankle sprains.
A sprained ankle is common among sporting populations such as high school athletes, elite basketball players, collegiate athletes, and military personnel.
A meta-analysis of 181 prospective epidemiological studies on ankle sprains across different populations and data sources found that the overall incidence of acute ankle sprains was higher in females than in males (13.6 vs. 6.9 per 1,000 exposures). The incidence rate also appeared to decline with age, with children experiencing an estimated rate of 2.85 per 1,000 exposures, which dropped to 1.94 per 1,000 in adolescents and 0.72 per 1,000 in adults. However, the peak incidence varied by gender, as one study reported that females had the highest incidence between ages 10–14, while males peaked between ages 15–19.
Symptoms
Symptoms of Sprained ankle may vary depending on the severity of the damaged ligaments. The following are primary indicators of sprained ankles.
Pain
Pain is one of the primary symptoms of sprained ankles. You may experience pain when you bear weight on the affected foot. Pain can be severe or mild, depending on how much your ligament has been damaged.
Swelling
Swelling occurs when the affected area undergoes inflammation in response to an injury.
Bruising
A sprained ankle occurs when your ankle ligaments tear or overstretch when you roll or twist. When your ankle ligaments tear, you bleed, resulting in a symptom called bruising, Bruising is when you bleed under the skin due to a torn vessel. Bruising can be mild or severe depending on the severity of the sprain.
Restricted Range of Motion
Sprain may make it difficult for you to make a move. Pain and stiffness may inhibit you from rotating the affected foot or pointing your toes.
Instability in the Ankle
A severe sprain can make your ankle unstable due to significant damage to the ligaments.
Tenderness
You may experience pain and discomfort in the affected area, once you press it. This clearly shows that there is a damaged ligament under the skin.
Causes of Sprained Ankle
You will know you have a sprain when your ankle shifts from its normal position. The main causes of sprained ankles are twisting, rolling, and falling. Some of the other causes of a sprain include:
Traumatic Movements
Examples of traumatic movements include: Inversion ankle sprain, eversion ankle sprain, and high ankle sprain.
An inversion ankle sprain occurs when your foot rolls inwards causing stress on the lateral ligaments. You will experience an inversion ankle sprain when you:
- Fall on uneven surfaces such as potholes
- Land incorrectly after jumping when playing games such as basketball and gymnastics
- Unexpectedly changing your direction while walking or running
Eversion ankle sprains occur when your foot rolls outwards. Causing stress on the deltoid ligament. An example of an eversion ankle sprain is when your foot turns inside out while participating in sports such as basketball, tennis, or soccer.
A high ankle sprain is caused by forcibly twisting your foot outwards while participating in sports activities such as skiing and hockey. High ankle sprain affects the ligaments between the tibia and fibula.
Environmental Factors
Inappropriate footwear is another cause of sprains. Unsupportive shoes such as flip-flops, high heels, and worn-out sneakers can lead to rolling, falling, or twisting.
You may roll your ankle while walking or running on uneven surfaces such as icy roads, grass fields, and rocky trails.
Risk Factors
Several factors can increase the susceptibility of a sprained ankle, they include :
A History of Ankle Sprains
According to (Hupperets et al., 2009) people with a previous history of ankle sprains are 5 times more likely to have sprained ankle. Previous sprained ankle injuries weaken your ligaments increasing the risk of another sprain.
Poor Physical Conditioning
As an athlete with a balance deficit, you will encounter risks of sprain while participating in sports activities. Balance deficit is caused by weak neuromuscular control making it hard for you to respond to sudden movements. An athlete should have good postural control to actively participate in sports activities.
Inadequate Warm-up Before Exercise
Stiff and cold ligaments, are less flexible and therefore likely to overstretch. Insufficient dynamic stretches can lead to sprained ankle injuries.
Poor Recovery
If you have not yet recovered from a sprain, you may encounter recurrent sprains and chronic instability when you rush to join sports.
High-Risk Sports
Participating in high-risk sports that require frequent jumping and sudden stops or directional changes can be a sprain risk factor. Examples of high-risk sports include: basketball, football, volleyball, badminton, hiking, and trail running.
Diagnosis
The doctor diagnoses your sprained ankle through a physical examination. Physical examination focuses on identifying the affected ligaments and your range of motion.
The doctor identifies your range of motion by asking you to move your foot to understand which positions are causing discomfort.
The doctor will also touch the injured parts to identify symptoms such as sweating and tenderness.
If your ligaments are severely damaged, a physical examination is not enough to give the best results. Your doctor may conduct image tests to understand the extent of the damage. Some of the image tests that might be used include:
- Ultrasound: An ultrasound produces real-time images using sound waves. During this test, tendons and ligaments are cross-examined in various foot positions.
- MRI(Magnetic Resonance Imaging): This type of test uses strong waves and magnetic fields to produce 3D images of your ligaments. MRI is used for severe sprains it is used to check on torn ligaments, bruises, and injured tendons.
- Xray: Your doctor will take an x-ray test if they suspect borne fractures. The doctor may suspect you have a fracture if they notice tender bones on the lateral and medial malleolus, an inability to carry your weight after taking a few steps, and sharp pain in the ankle. To conduct an x-ray, the doctor passes radiation through your body to get images of the bone in your ankle.
- CT scan: A CT scan combines different X-ray angles to make 3D images.
Treatment Options
Sprained ankle treatment may be done depending on the severity of the injury. Some of the treatment options include: Medication, surgery, self-care tips, therapy, and support services.
Self-Care Tips
Some of the self-care tips your doctor might recommend include:
Rest: Minimize the number of physical activities that would put more pressure on your injured ankle. Physical activities such as running and jumping would add stress to the sprain.
Ice: Using an ice pack or keeping your ankle in cold water helps reduce the swelling. If you are using the ice pack, remember to cover the area of treatment with a towel to protect the skin. You can use the ice pack after every 3 hours until the swelling reduces. You can take ice baths for 15 minutes but if you have vascular diseases or diabetes, consult your doctor first.
Compression: Compress your ankle with an elastic ankle sleeve or elastic bandage to minimize swelling.
Elevation: Elevate your ankle as high as you can while seated to reduce swelling. Elevating your uncle reduces inflammation by draining excess fluids.
The first 4 tips are usually defined using an acronym “RICE” to make it easier for someone to remember.
Support devices: Lastly, you can use support devices such as crutches to avoid putting more weight on the sprain.
Medication
You can use over-the-counter painkillers such as Ibuprofen to help in managing pain and reduce swelling. Other over-the-counter pain relievers for sprains include acetaminophen and naproxen sodium.
Surgery
You should opt for surgery if the injury takes a long period to heal even after using physical self-care, therapy, and rehabilitative exercises.
Your doctor may recommend surgery to repair a ligament that has taken a long time to heal or make a ligament from other ligaments or tendons.
Rehabilitation and Recovery
Therapy
Your healthcare provider may recommend physical therapy for your ankle to heal properly. Physical therapy helps in restoring your mobility and strength. Some of the exercises that improve your stability, motion, and strength include:
- Balance training: Some of the exercises that may help in maintaining your balance include: a single leg stance, where you stand on your injured foot for 30 seconds and heel-to-toe walking to enhance coordination.
- Strengthening exercises: Strengthening exercises engage stabilizing muscles to improve stability and help loosen tight muscles. Examples include ankle circles, toe taps, and calf raises.
- Range of motion exercises: You can begin with gentle movement to enhance flexibility. For example, putting your clutches aside to bear the full weight.
Mild strains with no tear can take 1 to 3 weeks to recover. A partial tear, classified as Grade 2 severity, typically heals in 3 to 6 weeks. A full tear, or Grade 3 severity, may take approximately 3 to 6 months to heal.
Prevention Strategies
You can reduce the risk of getting a sprained ankle by observing the following preventive measures:
Always warm up before exercises or physical activities: Warming up improves your muscle flexibility, thus preventing future injuries. Examples of warm-up exercises include stretches and rises.
Also Read: Guide to Stretching Before a Run
Wear footwear that supports and stabilizes your ankles. A good foot wear should have a cushionable sole, firm heel, and good ankle support. Wear the right footwear for the right sport activity, for example, running shoes for jogging and hiking shoes for trails. Always avoid worn-out shoes.
Prioritize strength and flexibility training to increase blood flow, enhance flexibility, and activate your muscles. Strength and flexibility exercises include calf raises and single-leg balancing.
Lastly, be aware of your environment. Always ensure that your environment supports your physical activity. For example, you can avoid rocky and hilly playing grounds.
When to Seek Medical Attention
You should see your healthcare provider if you :
- Can’t walk Experience severe pain and swelling around your ankle
- The swelling and pain haven’t reduced after medication in the last 24 to 48 hours
Seeking medical attention helps your healthcare provider evaluate your sprain and provide better treatment.
Conclusion
In conclusion, a sprained ankle is a common injury that occurs when the ligaments in your ankles overstretch due to rolling or twisting.
Some of the causes of sprains include improper footwear, exercising in un-even services, and ankles among others. These causes can be prevented by wearing the right footwear, warming up properly, and including strength exercises in your routine.
A sprained ankle can be diagnosed through physical examination and image tests that prove the extent of your ligament damage treatments such as over-the-counter pain relievers, therapy, surgery, and self-care tips can help in reducing the intensity of the ligament damage.
As an athlete always prioritize your physical health to improve your performance.
References
https://www.healthdirect.gov.au/sprained-ankle
https://pmc.ncbi.nlm.nih.gov/articles/PMC6602402/
https://pubmed.ncbi.nlm.nih.gov/19589822/
https://www.bmj.com/content/339/bmj.b2684
https://www.health.harvard.edu/pain/recovering-from-an-ankle-sprain
