Ankle sprain: Causes, signs, and effective treatment options

Ankle sprains, while common, can vary significantly in severity and require appropriate treatment to ensure full recovery. This article provides an expert insight into an ankle sprain, including causes, signs and treatment options.

What is an ankle sprain?

An ankle sprain is a common injury that occurs when the ligaments (tough bands of tissue that connect bones to each other) are torn or stretched beyond their limits. This typically happens when the ankle is suddenly twisted, turned, or rolled in an awkward way, causing the ankle joint to move out of its normal position, and resulting in a sprain.

Ankle sprains are mostly caused during physical activities that involve quick changes in direction, jumping, or running. However, these injuries can also occur during everyday activities, such as when walking on an uneven surface or missing a step on a staircase.

What are the signs and symptoms of an ankle sprain?

The symptoms of an ankle sprain can vary depending on the severity of the injury, but generally include the following:

• pain, which typically occurs at the site of the sprain
• swelling, bruising, or discolouration of the skin around the ankle
• tenderness, particularly over the injured ligament
• a feeling of instability or of the ankle “giving way”
• limited range of movement in the ankle
• difficulty walking or placing weight on the affected foot

How is an ankle sprain treated?

Treatment focuses on reducing pain and swelling, promoting ligament healing, and restoring function to the ankle.

RICE protocol

The initial treatment for an ankle sprain usually involves the RICE protocol:

• Rest: Avoiding placing weight on the injured ankle.
• Ice: Applying ice to the injured area right away and doing this for 15-20 minutes every 2-3 hours during the first 48 hours after the injury.
• Compression: Using an elastic bandage to compress the ankle, manage swelling, and provide support to the injured area.
• Elevation: Keeping the injured ankle above heart level whenever possible.

Medications

Additionally, over-the-counter pain relievers such as ibuprofen can help manage pain and reduce inflammation. In some cases, your orthopaedic surgeon may prescribe stronger pain medication if the pain is severe.

Immobilisation

Depending on the severity of the sprain, immobilisation may be necessary. This could involve wearing a brace, splint, or cast to protect the ankle and prevent further injury whilst the ligaments heal. Immobilisation can also help to reduce pain and swelling.

When is surgery required to treat an ankle sprain?

Surgery is rarely required for ankle sprains, but it may be necessary if:

• The ankle continues to feel unstable or gives way after several months of conservative treatment.
• The ligament is severely or completely torn and the ankle remains unstable even after initial treatments.
• The sprain is accompanied by fractures, dislocations, or significant damage to other structures in the ankle, such as bones, tendons, or cartilage.

Surgery is only considered after non-surgical treatments have failed to restore stability and function to the ankle. Common procedures include:

• Ligament repair: The torn ligament is sutured back together to restore its original position and function.
• Ligament reconstruction: In cases where the ligament is too damaged to be repaired, a tendon graft from another part of the body may be used to reconstruct the ligament.
• Arthroscopy: This minimally invasive procedure allows your surgeon to view and repair the inside of the ankle joint using a small camera and instruments. This option may be used to remove damaged tissue or to address other issues in the joint.

How long does it take to recover from an ankle sprain?

With a mild sprain, recovery typically takes 1 to 3 weeks. During this time, you may gradually return to normal activities as pain and swelling subside.

With a moderate sprain, recovery may take anywhere between 3 to 6 weeks. You may need to wear a brace or use crutches during the early stages of healing. Additionally, physiotherapy is often recommended, to restore strength, flexibility, range of motion, and balance in the ankle.

With a severe sprain, recovery can take several months. You may need to wear a cast or boot, followed by a period of physiotherapy. In cases where surgery is required, the recovery period may be longer.

During recovery, it’s important to follow your surgeon’s recommendations and avoid activities that could re-injure the ankle. Gradual return to sports should only occur when the ankle has fully healed and regained strength.