Sprained Ankle

Sprained ankle is a common injury in all age groups, resulting from stretch or tear of ligament that support the bones of ankle. The ligament may be injured by rolling, twisting, or turning of ankle. In most of the cases, the injury is to the ligaments on the outer side of the ankle. 

Symptoms of sprained ankle range from mild to severe depending on the extent of ligament damage. Minor injuries can be treated with simple home remedies. Severe injury cause swelling and pain in the ankle, and require professional help. If left untreated, sprain weakens the ankle and increases the risk of further injury.

Pain is the most common symptom of sprain in the ankle. Other symptoms are: 

• Swelling of the ankle
• Bruising
• Restricted range of motion
• Instability of ankle
• Tenderness in and around the region

Instability of ankle occur when the ligament is completely torn or the joint is dislocated. Severe symptoms are often accompanied by a ‘pop’ sound at the time of sprain. 

Sprained ankle is caused when the ligaments in the ankle are stretched beyond limit or is torn. This may result from sudden movements like rolling, twisting, or turning of the ankle. Thus a fall may cause an ankle to twist leading to ligament tear. Jumping from a height and landing on one foot is another common cause of ankle sprain. 

Walking, running, and exercising on uneven surface causes strain on the foot, resulting in sprain. High impact sports that requires sudden cutting actions, like football, soccer, and basketball, lead to twisting and rolling of foot. Major risk factors for sprained ankle are participating in high impact sports activities, and history of ankle injury.

Sprained ankle is diagnosed during physical examination.

During physical examination, palpating or pressing around the ankle helps to identify the damaged ligament. The range of motion is assessed by moving the ankle in different directions. Stiff and swollen ankles are generally unable to move. 

Extent of damage to the ligament is assessed based on swelling, pain, and bruising in the ankle. Imaging techniques are recommended for severe ligament injury to evaluate the extent of damage to soft tissues or bones.

X-ray, MRI, and CT scans provide a detailed image of the tissues and injuries, if any.

Sprained ankle can be treated without surgery. Even severe symptoms of complete ligament tear are treated by immobilizing the ankle. Sprained ankle is usually treated in three steps. Resting and reducing the swelling is the first step in treatment. 

In the second step, the range of motion of the ankle is restored. This is followed by improving the strength and flexibility of the joint. Last step of treatment is characterized by gradual return to activities. The treatment may take 2 weeks for mild injuries and about 6-12 weeks for severe ligament injuries. 

Non-steroidal anti-inflammatory medications help to control pain and swelling, and are often suggested for mild sprain. Crutches provide support and prevent extra pressure on the joint. Immobilizing the ankle supports and prevents sudden movements of the ankle during the healing phase of treatment. 

Cast-boot or air stirrup-type brace also provides support to the damaged ankle. For severe sprains, short leg cast or cast-brace are recommended for 2 to 3 weeks.

Physical therapy improves the flexibility and range of motion of the ankle. This method prevents stiffness and chronic ankle problems. Initial exercises in this therapy help to improve the range of motion and to prevent stiffness of ankle. 

As the next step in the therapy, simple exercises that strengthen the muscles and tendons of ankle are suggested. Balance training prevents further injuries to ankle. Agility and endurance exercises are added once pain and swelling are relieved. 

In some very rare cases, where the patient does not respond to non-surgical methods, surgery is recommended. In arthroscopy, a common surgical treatment, an arthroscope is used to remove loose fragments caught in the joint. Torn ligament is corrected with sutures and stitches in surgical reconstruction. 

Having good muscle strength, flexibility, and balance help in preventing ankle sprain. Warm ups are important before any physical activity. 

Walking or exercising on uneven surface should be avoided. Choose the right shoes that suit the activity. Avoid overstraining the muscles and stop an activity if it leads to pain or swelling.

Arnica montana is the common medication recommended for ankle sprain in homeopathy. Ruta graveolens, bellis, and hypericium are suggested for ankle and other muscle sprains. Ledum and rhus tox prevents bruising and stiffness of joints. 

Simple home remedies are ideal for mild form of ankle sprains. The RICE protocol is the most common treatment method followed at home. This includes: 

• Resting the ankle
• Ice application three to four times
• Compression dressings
• Elevating the legs

There are several complications associated with sprained ankle.

If left untreated, sprained ankle may lead to chronic pain, joint instability, and arthritis.