Ankle Sprains: Symptoms, Treatments and Prevention

By Alyssa Herrera-Set, M.S.P.T., D.P.T.

What is an ankle sprain?

An ankle sprain or twisted ankle is a common injury which affects people of all ages and activity levels. Ankle sprains occur when one or more of the ligaments of the ankle joint are stretched past their normal range of motion. Ankle sprains happen when the foot is planted unevenly on the ground causing the ankle to roll inward or outward. A severe ankle sprain may be associated with a complete tear of a ligament. In some cases, bone detachment occurs along with the ankle sprain.

What are the symptoms?

With an ankle sprain, there may be pain upon moving the foot, standing on the injured leg, or when touching the ankle. Oftentimes, there is swelling and bruising. When symptoms are severe, a physician may order x-rays to rule out a broken bone.

What should you do when you have an ankle sprain?

You may suffer an ankle sprain when you’re out hiking. If you are able to walk back to your home base with minimal pain, make sure to not remove your shoes until you return to a place in which shoes will no longer be necessary because your foot or ankle may swell to the point in which you will not be able to put on your shoes again.

As soon as possible, you can take care of your ankle sprain with protection, rest, ice, compression, and elevation (PRICE). For the first 24 – 72 hours, protect the ankle with an ankle brace, rest your ankle by decreasing your activity until the pain subsides, place ice on your ankle or place your foot in a bucket of icy water for 15-20 minutes, several times per day, compress your ankle with an elastic compression wrap, and elevate your ankle above the level of your heart for several hours a day.  After the first 72 hours, you should start to feel an improvement in symptoms. If the level of pain or severity of symptoms persist, you should seek medical attention. Additionally, if there is any numbness, splotchy red patches of skin, or a change of temperature of the leg, you should seek medical attention immediately.

Early rehabilitation includes ankle range of motion exercises such ankle circles, pointing and flexing the foot, and moving the foot right to left. A physical therapist can help you create a complete rehabilitation plan which may include balance exercises, strengthening, and stretching. After days or weeks of limping due to discomfort, you may develop some compensatory mechanisms and gait training as well as stretching and strengthening of the entire leg may be necessary.

How can you avoid an ankle sprain?

Previously sprained ankles are often re-injured. Performing ankle strengthening and balance exercises is a key component in preventing repeat injuries. Additionally, to avoid ankle sprains, you should wear shoes that are supportive of the foot with soles less than 1” in height. In sport activities, some people may benefit from wearing shoes that cover the ankle.

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