An ankle sprain is a common injury and usually results when the ankle is twisted, or inverted. The term "sprain" signifies injury (below) to the soft tissues, usually the ligaments, of the ankle. An ankle sprain is a common injury and usually results when the ankle is twisted, or inverted. The term "sprain" signifies injury (below) to the soft tissues, usually the ligaments, of the ankle.
Anatomy
A ligament is made up of multiple strands of tissue - similar to a nylon rope. A sprain results in tearing of the ligaments (right). The tear can be a complete tear of all the strands of the ligament or a partial tear, where a portion of the strands of the ligament are torn. The ligament is weakened by the injury - how much depends on the degree of the tear. The lateral ligaments (below) are by far the most commonly injured ligaments in a typical inversion injury of the ankle.
On the lateral side of the ankle there are three ligaments (below) that make up the lateral ligament complex. These include the anterior talofibular ligament (ATF), the calcaneofibular ligament(CF) and the posterior talofibular ligament (PTF). The very common inversion injury to the ankle usually injures the anterior talofibular ligament and the calcaneofibular ligament. The ATF ligament keeps the ankle from sliding forward and the CF ligament keeps the ankle from rolling over on its side.
Symptoms
Initially the ankle is swollen, painful, and may turn echymotic (bruised). The bruising, and the initial swelling, is due to ruptured blood vessels from the tearing of the soft tissues. Most of the initial swelling is actually bleeding (.avi movie) into the surrounding tissues. This initial swelling due to bleeding then increases due to edema fluid leaking into the tissues as well over the next 24 hours.
Diagnosis
The diagnosis of an ankle sprain is usually made by examination of the ankle and xrays to make sure that there is no fracture of the ankle. If there is a complete rupture of the ligaments suspected, your doctor may order stress xrays (below) as well. These xrays are taken while someone twists or "stresses" the ligaments.
Medical Treatment
Treatment begins initially by:
· controlling swelling
· controlling pain
· controlling weight bearing
· Elevation will help control the swelling
· Gentle compression and ice will control swelling
· Mild pain relievers will help with the pain
· Crutches will prevent weight bearing.
Casts have fallen out of favor, and as treatment progresses, early weight bearing (right) has been shown to be beneficial. Braces that can be worn to support the ankle - but still allow weight bearing are the most popular treatment method today. Healing of the ligaments usually takes about 6 weeks. The swelling may be present for several months. A physical therapist may be suggested to help you regain full function of your injured ankle. (See rehabilitation below)
Ankle Instability
In a small number of cases, the ligaments will not heal back as strong as normal. This results in an ankle that is unstable and has a tendency to give away, or twist again very easily. Ankle instability (right) can lead to an ankle that is sore and painful, sometimes swollen, and untrustworthy on rough terrain. If your ankle ligaments do not heal back adequately following an ankle sprain there are several things that may be suggested by your doctor.
A physical therapy program (below) may help strengthen the muscles around the ankle to help make the ankle more reliable. The therapy is also necessary to "retrain" the proprioceptive nerves around the ankle that have been torn with the ligament. These nerves are important in telling our brains how to use the muscles to allow the joints to properly function. An ankle brace may also help control some of the instability and prevent the ankle from giving way.
Surgery
If all these simple measures fail, surgery may be suggested to reconstruct the ligaments that have been torn. Surgery involves making an incision (left) on the side of the ankle. A portion of the tendon (.avi movie) called the peroneus brevis is used to reconstruct the lateral ligaments.
A drill hole is made in the fibula, near the attachment the original ligament. A second drill hole is made in the area where the ligaments attached to the talus. The tendon graft (.avi movie) is then woven these holes to recreate the ligament complex.
After surgery, you will usually be placed in a cast or brace for about 6 weeks to allow the tendon reconstruction to heal. Following removal of the cast, physical therapy will be required to regain full use of the ankle.
Other treatment choices may be used to further limit pain and inflammation. Examples include contrast baths with hot and cold applications, cold whirlpool, or electrical stimulation.
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i dance and i sprained my foot sooooo bad...i feel like i have no foot...and when i was iceskating it poped like 2 times :/
MikaylaisLegit 1 year ago 3