Ankle Sprain

What is an ankle sprain?

An ankle sprain happens when one or more ligaments in your ankle joint stretch or tear. The ankle joint is where your lower leg bones and the bones in your foot meet. A ligament is strong elastic tissue that connects one bone to another. Ligaments help keep your joints stable (secure). With an ankle sprain, you may not be able to move your ankle and walk like you normally do. It may be hard for you to put any weight on your injured ankle and foot.

What causes an ankle sprain?

You may get an ankle sprain when your ankle is suddenly forced out of its normal position. An ankle sprain may occur when you fall. You may also get an ankle sprain if you twist your ankle when you step, or land a jump. Ankle sprains may occur when your ankle and foot twist inward.

What increases my risk for an ankle sprain?

The following may increase your risk for an ankle sprain:

• You have problems walking or staying balanced.
  
  
• You have sprained your ankle before.
  
  
• Your ankle is not stable. You may have been born with weak ankle ligaments.
  
  
• Your foot or lower leg muscles are weak.

What are the signs and symptoms of an ankle sprain?

You may have the following:

• Pain and numbness (loss of feeling) in your ankle.
  
  
• Swelling, bruising, or a change in the shape of your ankle.
  
  
• Tenderness (pain when touched) around your ankle. Your ankle may also feel cool to touch.
  
  
• Trouble moving your ankle or toes.
  
  
• Trouble standing on your injured ankle and foot.
  
  
• Trouble walking.

How is an ankle sprain diagnosed?

Your caregiver will ask you about your signs and symptoms. Tell him how you hurt your ankle, and if you have had an ankle sprain before. Tell your caregiver if you heard a snap or pop when you hurt your ankle. Your caregiver will feel your foot and ankle to check for painful or numb areas. He may check for breaks in the skin and look for other injuries to your knee and leg. He may check the movement and strength of your ankle and foot. Tell your caregiver if certain movements cause you pain. You may also need the following:

• Joint x-ray: An x-ray is a picture of the bones and tissues in your ankle joint. You may be given a shot of dye in your ankle joint before the x-ray. This dye helps your ankle joint show up better on the x-ray. People who are allergic to iodine or shellfish (lobster, crab, or shrimp) may be allergic to some dyes. Tell your caregiver if you are allergic to shellfish.
  
  
• Bone scan: A bone scan test looks at the bones in your ankle joint. You are given a small, safe amount of radioactive dye in an IV. An IV is a tube put in your vein to give you medicine and liquids. Pictures are taken of your ankle to check for broken bones or other problems.
  
  
• Magnetic resonance imaging: During magnetic resonance imaging (MRI), pictures are taken of your ankle. An MRI may be used to look for broken bones, tissue damage, or edema (fluid buildup) in your ankle. You will need to lie still during the MRI. Never enter the MRI room with any metal objects. This can cause serious injury.
  
  
• Peroneal tenography: A peroneal tenography test looks 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 tissue tears and swelling in your ankle.
  
  
• Ultrasound: An ultrasound test uses sound waves to look inside your body. Pictures of your ankle joint and tissues will appear on a TV-like screen.

How is an ankle sprain treated?

The goal of treatment is to decrease your pain and swelling, and protect your ankle so it can heal. You may need any of the following:

• Ankle supports: A brace, cast, or splint may be put on your ankle for support, and to decrease its movement. Braces, casts, and splints may help decrease pain, and prevent more damage to your ankle. Your caregiver may give you crutches to help you walk. Crutches will help you keep your weight off your ankle. Ask your caregiver for more information about braces, splints, casts, and how to use crutches.
  
  
• Medicines:
  
  
  • Pain medicine: You may be given medicine to decrease or take away pain. Do not wait until the pain is severe before you take your medicine.
    
    
  • Tetanus shot: You may need a tetanus shot if you have breaks in your skin from your injury. A tetanus shot is a shot of medicine to prevent you from getting tetanus. The shot is normally given into your arm. You should have a tetanus shot if you have not had one in the past 5 to 10 years. Your arm can get red, swollen, and sore after getting this shot.
  
  
• Physical therapy: Your caregiver may have you go to physical therapy. A physical therapist shows you exercises to strengthen your ankle, and improve your balance. These exercises may also help to decrease your pain.
  
  
• Surgery: You may need surgery if your ankle sprain does not heal with other treatments. Surgery may be done to repair or replace a torn ligament. 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.

What can I do to help my ankle sprain heal?

• Rest your ankle: You may need to rest your ankle and avoid activities that cause you pain. Rest allows your ligaments to heal.
  
  
• Ice your ankle: Ice causes blood vessels to constrict (get small), which helps decrease swelling and pain. Ice may also help prevent tissue damage in your ankle. Put crushed ice in a plastic bag and cover it with a towel. Put the ice pack on your foot for 15 to 20 minutes every hour. Use the ice for as long as your caregiver says you should.
  
  
• Compress your ankle: Your caregiver may suggest you wrap an elastic bandage around your ankle. An ankle wrap will compress (put pressure on) your ankle to help decrease swelling. Compression also helps support your ankle, and allows it to heal. Wear your ankle wrap for as long as your caregiver tells you to. Ask your caregiver for instructions about how to wrap your ankle.
  
  
• Elevate your ankle: When you sit or lie down, keep your ankle at, or above the level of your hips. Elevation may help decrease pain and swelling.

How can I prevent another injury?

• Maintain a healthy body weight to decrease the pressure on your ankle.
  
  
• Wear shoes that fit right and support your ankle. Avoid wearing high heels.
  
  
• Strengthen your leg and foot muscles by doing exercises your caregiver suggests.
  
  
• Start exercising slowly, and do more as you get stronger.
  
  
• Stretch and warm up before you exercise or play sports.
  
  
• Pay attention to ground surfaces when you walk or run to help prevent falling and twisting your ankle.
  
  
• Use ankle braces or wraps, as directed by caregivers, to support your ankle during exercise and sports.

What are the risks of an ankle sprain?

• You may have an allergic response to the medicines used to treat your 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 may 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.
  
  
• You may get a blood clot in your leg. This can cause pain and swelling, and it can stop blood from flowing where it needs to go in your body. The blood clot may break loose and travel to your lungs or brain. A blood clot in your lungs can cause chest pain and trouble breathing. A blood clot in your brain can cause a stroke. These problems can be life-threatening.
  
  
• Without treatment, your pain, weakness, and stiffness may get worse. You may have a higher risk of arthritis in your ankle. 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.

Where can I find more information?

Contact any of the following:

• American Academy of Family Physicians
  11400 Tomahawk Creek Parkway
  Leawood , KS 66211-2680
  Phone: 1- 913 - 906-6000
  Phone: 1- 800 - 274-2237
  Web Address: http://www.aafp.org
  

• American Academy of Orthopaedic Surgeons
  6300 North River Road
  Rosemont , IL 60018-4262
  Phone: 1- 847 - 823-7186
  Web Address: http://www.aaos.org/
  

When should I call my caregiver?

Call your caregiver if:

• You are unable to walk more than a few steps.
  
  
• Your ankle pain gets worse.
  
  
• You have questions or concerns about your condition or treatment.

When should I seek immediate help?

Seek immediate help or call 911 if:

• The skin on, or near your ankle feels cold, or turns blue or white.
  
  
• The skin on, or near your ankle is tight, raised, and swollen.
  
  
• You are unable to put any weight on your ankle or foot.
  
  
• You have severe pain in your ankle and leg with activity that goes away with rest.
  
  
• You have severe pain in your leg or foot that does not get better with medicine.
  
  
• Your ankle, foot, or toes become numb or tingle.

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.

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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.

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