According to the American Academy of Orthopedic Surgeons, approximately
25,000 people sprain their ankle per day. If you have never sprained your ankle, someone you know probably has. Ankle sprains are painful and can often affect your quality of life.
The ankle itself is made up of three bones, the tibia or inside ankle bone, the fibula or outside ankle bone, and the talus that sits in between the two. All these bones are held together by ligaments. There are three ligaments on the outside of the ankle: the posterior talofibular (PTF), the calcaneofibular (CF), and the anterior talofibular (ATF). On the inside of the ankle there are four ligaments collectively known as the deltoid ligament: the posterior tibiotalar, the tibiocalcaneal, the tibionavicular, and the anterior tibiotalar. When we “roll” our ankle we generally injure the ATF ligament.
The term sprain is used to describe a ligament injury.
There are three possible degrees of ligament injury: Grade I, Grade II, and Grade III. A Grade I ankle sprain happens when ligaments are slightly stretched causing minor damage to the ligament fibers. Grade I sprains usually involve pain, bruising, and swelling but normally do not cause difficulty walking. A Grade II sprain occurs when ligaments partially tear. Within the hour, the ankle may feel painful, bruised, and swollen, and the ankle may become “loose”, also known as laxity. With a Grade II, running and or walking may or may not be possible. A Grade III sprain occurs when there is a complete tear of the ligament and gross instability is present. Grade III ankle sprains result in immediate pain, swelling and the inability to walk or run.
The treatment for an ankle sprain begins with controlling the symptoms. The principle of RICE applies within the first 72 hours of an ankle sprain. RICE stands for
Rest, Ice, Compression, and Elevation.
Rest includes staying off of the injured ankle – simply “if it hurts, don’t do it”. Crutches and bracing may be needed.
Ice should be applied to the injured ankle for approximately 15 to 20 minutes three times a day.
Compression involves a loose elastic bandage wrapped from toes to calf.
Elevation, lying down with ankle above heart, helps to decrease swelling. If symptoms persist greater than 5 to 7 days consult orthopedic advice for further evaluation and x-ray. Brockton Physical Therapy speeds up the recovery process by utilizing ultrasound to decrease swelling and increase healing, educating in appropriate exercises to increase range of motion and strength, and applying electrical stimulation to decrease pain. If you're dealing with an ankle injury and need help give us a call or ask your doctor if physical therapy is an option for you.
