ANKLE SPRAIN

If you’ve suffered from a serious ankle sprain, please Schedule an appointment with one of our orthopedic specialists as soon as possible.

What is a Sprain?

Sprained ankles occur when the ankle forcefully twists or turns in an unnatural way. This unnatural movement can damage or stretch the ligaments in the ankle joint that help stabilize the foot.

The stabilization provided by Ligaments helps prevent movement beyond a standard range of motion. In most cases, ankle sprains tend to roll outwards, damaging the ligaments on the outer edge of the foot.

Ankle sprains come in a variety of grades depending on the severity of the injury, which also determines treatment options. Most cases of sprained ankles will heal on their own with rest and pain management medication, although patients should still consult with an orthopedic specialist to evaluate serious sprains and diagnose an appropriate treatment.

How Serious Is It?

We have all experienced a slight twist of an ankle at some point in our lives, whether it be in sports, walking on an uneven surface, or for some folks, just a slight misstep of a heeled shoe. The more common mechanism of injury is an inversion or plantarflexion sprain, which involves the lateral aspect of the ankle. The lateral ankle, or outside of the ankle, is made up of 3 primary ligaments, the anterior talofibular ligament (ATFL), the calcaneofibular ligament (CFL), and the posterior talofibular ligament (PTFL). Two of these three ligaments are often affected during a mild to moderate ankle sprain (figure a). During an ankle sprain, the ligaments are stretched and may partially tear, which causes a cascade of inflammatory responses to cause the ankle to swell, and subsequently become painful. 

In some cases, the ankle swells instantaneously and can be intolerable to walk on. In most instances, the injury will linger for several weeks. Resting, icing, compressing the ankle with a brace, and elevating the foot and ankle can alleviate the pain. Over-the-counter anti-inflammatory medications can prevent pain from worsening during the first few days of the injury. 

In severe ankle sprain injuries, there may be a high ankle sprain or a cartilage injury involved. In a high ankle sprain, the ligaments that hold the two long bones above the ankle, the tibia and the fibula, better known as the ankle syndesmosis, anterior inferior tibiofibular ligament (AITFL), and the posterior inferior tibiofibular ligament (PITF), are completely torn.  The stability of the ankle joint depends on the higher ankle joint ligaments. 

A cartilage injury, also known as osteochondritis dessicans, is a fracture to the ankle cartilage causing a defect that is essentially analogous to a pothole on the surface of a road (Figure B). A fracture of the ankle cartilage often leads to significant pain, instability of the ankle, and early post-traumatic arthritis. 

Fig A. A lateral ankle sprain demonstrating a tear of the anterior talofibular ligament and the calcaneofibular ligament, two of the most commonly affected.

Figure B. An osteochondral defect is demonstrated on advanced imaging as a fracture of the cartilage of the talus. 

What is the difference between a sprain and a strain?

The main difference between a sprain and a strain: A sprain injures the tissue that connects the bones together, while a strain injures a muscle or the tissue that attaches muscle to bone. 

What are the symptoms of a sprain?

Pain, tenderness, limited motion, and weakness around the injured area. Sometimes the sprained area will swell and bruise. Some people may hear a pop in the joint at the time of injury.

What causes an ankle sprain?

A sprain occurs when you overextend or tear a ligament while severely stressing a joint. Sprains often occur in the following circumstances:

Sprained ankles occur when the ankle forcefully twists or turns in an unnatural way. This unnatural movement can damage or stretch the ligaments in the ankle joint that help stabilize the foot. For example, walking or exercising on an uneven surface or landing awkwardly from a jump can result in an ankle sprain.

If you have any questions for our Texas based orthopedic specialists, give us a call at 817-697-4038, or contact us over the web. Tele-medicine appointments are also available.