Ankle Sprain

What is an ankle sprain?

An ankle sprain happens when 1 or more ligaments in your ankle joint stretch or tear. Ligaments are tough tissues that connect bones. Ligaments support your joints and keep your bones in place.

What causes an ankle sprain?

An ankle sprain is usually caused by a direct injury or sudden twisting of the joint. This may happen while playing sports, or may be due to a fall. If you have problems with balance, or have weak muscles or ligaments, you are more likely to sprain your ankle.

What are the signs and symptoms of an ankle sprain?

You may have any of the following:

  • You have trouble moving your ankle or foot.

  • You cannot put weight on your injured ankle.

  • You have pain in your ankle, which may feel worse when you touch your ankle.

  • Your ankle is bruised, swollen, or has an odd shape.

How is an ankle sprain diagnosed?

Your caregiver will ask you about your injury and examine you. Tell him if you heard a snap or pop when you were injured. Your caregiver will check the movement and strength of your joint. You may be asked to move the joint yourself. You may also need the following:

  • Joint x-ray: This is a picture of the bones and tissues in your joints. A joint x-ray will show your caregiver if there is a fracture caused by the injury. You may be given dye as a shot into your joint before the x-ray. This dye will help your joint show up better on the x-ray. A joint x-ray with dye is called an arthrogram.

  • MRI: This scan uses powerful magnets and a computer to take pictures of your ankle. An MRI is used to look for ligament tears or other injuries. You may be given dye, also called contrast, before the test. Tell caregivers if you are allergic to dye, iodine, or seafood. Remove all jewelry, and tell caregivers if you have any metal in or on your body. Metal can cause serious injury. Tell caregivers if you cannot lie still or are anxious or afraid of closed spaces.

  • Peroneal tenography: This is a test to look at the tendons and soft tissues in your ankle. Tendons are cords of tissue that attach your muscles to your bones. Dye is injected into a tendon in your ankle. An x-ray machine is used to look for swelling and tissue damage in your ankle.

  • Ultrasound: An ultrasound uses sound waves to show pictures of your ankle on a monitor. This test is used to look for swelling and tissue damage in your ankle.

How is an ankle sprain treated?

  • Support devices: You may need a brace, cast, or splint to limit your movement and protect your joint. You may need to use crutches to decrease your pain as you move around.

  • Medicines:

    • Pain medicine: You may be given medicine to take away or decrease pain. Do not wait until the pain is severe before you take your medicine.

    • Td vaccine: This vaccine is a booster shot used to help prevent diphtheria and tetanus. The Td booster may be given to adolescents and adults every 10 years or for certain wounds and injuries.

  • Physical therapy: You may need to see a physical therapist to teach you special exercises. These exercises help improve movement and decrease pain. Physical therapy can also help improve strength and decrease your risk for loss of function.

  • Surgery: You may need surgery to repair or replace a torn ligament if your sprain does not heal with other treatments. Your caregiver may use screws to attach the bones in your ankle together. The screws may help support your ankle and make it stable. Ask your caregiver for more information about surgery to treat your ankle sprain.

How can I manage my ankle sprain?

  • Rest: Rest your joint so that it can heal. Return to normal activities as directed.

  • Ice: Ice helps decrease swelling and pain. Ice may also help prevent tissue damage. Use an ice pack or put crushed ice in a plastic bag. Cover the ice pack with a towel and place it on your injured ligament for 15 to 20 minutes every hour. Use the ice for as long as directed.

  • Compress: Ask if you should wrap an elastic bandage around your injured ligament. An elastic bandage provides support and helps decrease swelling and movement so your joint can heal. Wear as long as directed.

  • Elevate: Keep your injured ankle raised above the level of your heart as often as you can. This will help decrease or limit swelling. Elevate your ankle by resting it on pillows.

How can I prevent another ankle sprain?

  • Let your ankle heal: Find out how long your ligament needs to heal. Do not do any physical activity until your caregiver says it is okay. If you start activity too soon, you may develop a more serious injury.

  • Take it slow: Slowly increase how often and how long you exercise or train. Sudden increases in how often you train may cause you to overstretch or tear your ligament.

  • Always warm up: Always warm up and stretch before you exercise or play sports.

  • Use the right equipment: Always wear shoes that fit well and are made for the activity that you are doing. You may also use ankle supports, elbow and knee pads, or braces.

What are the risks of an ankle sprain?

  • Painful scar tissue may form in your ankle, and you may need surgery to remove it. Surgery to repair your ankle sprain may damage the nerves, tissues, and blood vessels in your ankle. After surgery, you could get an infection. Your ankle may feel stiff and you may get arthritis, which causes joint pain and swelling. Even after treatment, your ankle may be weak, and you may have problems walking.

  • Without treatment, a sprain may cause weakness of your joint or problems with movement. Your symptoms may worsen over time. The soft tissue in your ankle may become trapped between bone and the injured ligament. This may increase your pain and further decrease your ankle movement. Your ankle may become very weak, and you may feel that it gives out on you when you walk. Ankle weakness may increase your risk for other injuries and cause bone and soft tissue damage in your ankle. Severe swelling inside your ankle and leg may damage your nerves, muscles, and blood vessels.

When should I contact my caregiver?

Contact your caregiver if:

  • Your pain does not go away, even after treatment.

  • You have questions or concerns about your condition or care.

When should I seek immediate care?

Seek care immediately or call 911 if:

  • You have severe pain in your ankle.

  • Your foot or toes are cold or numb.

  • Your ankle becomes more weak or unstable (wobbly).

  • You are unable to put any weight on your ankle or foot.

  • Your swelling has increased or returned.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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