One of the most common foot/ankle injuries seen by physical therapists is a lateral ankle sprain. If you’ve played sports competitively or for recreation, the chances are that you have experienced a lateral ankle sprain in some form or fashion. However, something as simple as missing a stair on the way down the steps can be the cause of this injury. By the end of this article, you’ll know a bit more about the anatomy of the ankle, the varying degrees of an ankle sprain, and some basic means of immediate treatment should you or someone you care about experience this injury.
There are two joints in the body that have to balance both stability and mobility more than all the other joints. The ankle is one of them; the shoulder is the other in case you were wondering. If you imagine walking barefoot on a sandy beach, you’ll realize that your foot and ankle has to make many intuitive adjustments to ensure that you don’t have to look down at your feet the whole time to maintain your balance. The fancy word for this is proprioception. It’s the body’s internal mapping system. It allows you to walk with your head up, scanning your environment instead of worrying about where your feet are with every step.
The anatomy of your ankle lends itself to more motion when you turn your ankle inward (this is called inversion) than when you turn your ankle outward (eversion). Therefore, you are more prone to injure the outside of your ankle (lateral ankle sprain) than the inside (medial ankle sprain). Additionally, the structures that connect bone to bone (ligaments) on the medial side of the ankle are far less flexible than those on the lateral side. Therefore, lateral ankle sprains are far more common. It usually occurs when you roll your ankle past it’s normal range of motion and usually occurs in a weight bearing position. The positioning of your foot combined with your body weight will cause a sprain to occur. Consequently, the quality of your proprioception is temporary impaired, which is why you are more prone to re-sprain your ankle in the early stages of recovery than in the later stages.
There are varying degrees of severity when discussing a lateral ankle sprain. These are rated from grade one to grade three. Grade one is considered a mild sprain. Grade two is considered a moderate sprain. Grade three is considered a strain or complete tearing of the ligament(s) on the lateral side of the ankle. If the grade three strain is severe enough, it can cause damage to the bone that it’s attached to. This is called an avulsion fracture.
When a lateral ankle sprain occurs, you’ll likely experience several of the following symptoms: severe pain, difficulty with weight bearing, swelling around the ankle, heat/warmth around the joint, and a feeling of stiffness compare to your uninjured side. The immediate treatment for these symptoms can be remembered using the acronym ‘RICE.’ It stands for rest, ice, compression, and elevation. You may need crutches for the first few days but it is recommended to try to start gently moving your ankle through the pain to avoid loss of range of motion. Over the counter medication for pain relief may also help but if you are unsure of which medication to use, consult with a pharmacist or with your physician.
If you decide to go and see an orthopedic doctor, you may have an x-ray or MRI done at the doctor’s discretion to determine the severity of your injury. You will likely be referred to physical therapy to expedite your recovery and reduce the risk of chronic loss of ROM. Your physical therapist will assess your pain, strength, and ROM and develop a treatment plan to address your symptoms and gradually improve the stability of your foot/ankle to reduce the risk of re-injury.
If you or someone you know is suffering from an ankle injury, we encourage you to schedule a consultation with one of our experienced orthopaedic surgeons or physical therapists at CAO. We are committed to helping our patients achieve optimal outcomes and return to their active lifestyles as quickly and safely as possible. Schedule an appointment with a foot and ankle specialist today!