Sprained Ankle | Orthopaedics and Sports Medicine | Dartmouth-Hitchcock
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Sprained Ankle

Alternative name: Joint Sprain

What is a sprained ankle?

A sprain is a stretch and/or tear of a ligament (a band of fibrous tissue that connects two or more bones at a joint). With a sprained ankle, one or more ligaments around the ankle can be injured at the same time. The seriousness of the injury will depend on whether a tear is partly or completely torn and on the number of ligaments involved. The ankle joint is supported by several outside and inside ligaments. More than 25,000 people sprain their ankles each day in the United States.

What are the signs of a sprained ankle?

  • Pain in the ankle
  • Swelling of the ankle and/or foot
  • Bruising
  • Instability
  • Inability to move and use the ankle

However, these signs and symptoms can vary in intensity, depending on the severity of the sprain. Sometimes people feel a pop or tear when the injury happens.

What causes a sprained ankle?

Most ankle sprains happen when the foot turns inward as a person runs, turns, falls, or lands on the ankle after a jump or fall. High heels are often the cause of a sprained ankle.

How does a doctor tell if a patient has a sprained ankle?

The doctor will take some of the following steps to see if a patient has a sprained ankle.

  • Look at the injured site, see if the ankle can bear weight, and ask questions to get information to diagnose the severity of the sprain
  • Order an X-ray to make sure a fracture is not causing the pain and swelling
  • Request an MRI (magnetic resonance image), if the doctor needs to differentiate between a partial injury and a complete tear in a ligament

How is a sprained ankle treated?

Treatments for sprains can be thought of as having two stages: reducing swelling and pain, then beginning the rehabilitation. Some, but not all, of the following steps are normally taken.

Stage 1

  • Rest, ice, compression, and elevation (RICE) for the first 24 to 48 hours after the injury
  • An over-the-counter or prescription nonsteroidal anti-inflammatory drug, such as aspirin or ibuprofen, to help decrease pain and inflammation
  • For people with a moderate or severe sprain, particularly of the ankle, a hard cast may be applied, often after the initial swelling is less apparent
  • Severe sprains and strains may require surgery to repair the torn ligaments, muscle, or tendons. This surgery is usually performed by an orthopaedic surgeon.

Stage 2

  • An exercise program designed to prevent stiffness, improve range of motion, and restore the joint's normal flexibility and strength may be recommended
  • Physical therapy may be needed during this stage

The amount of rehabilitation and the time needed for full recovery after a sprain or strain depend on the severity of the injury and individual rates of healing. For example, a mild ankle sprain may require up to 3 to 6 weeks of rehabilitation; a moderate sprain could require two to three months. With a severe sprain, it can take up to 8 to 12 months to return to full activities. Extra care should be taken to avoid injuring the ankle again.

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