What Is Ankle Sprain?
An ankle sprain is when the ligaments of the ankle are injured or torn, resulting in twisting, rolling, or turning of the ankles. Ligaments connect bones to other bones throughout the body. Several ligaments in the ankle work to support the joint and keep the bones in the right positions. Sprains can cause partial or full ligament rips, ranging in size from microscopic to large. Depending on how many ligaments are implicated and how much they are damaged, a sprain's severity can vary dramatically. A prolonged or untreated severe sprain can weaken the ankle and increase the risk of reinjuring it if treatment and rehabilitation are not provided.
What Are the Types of Ankle Sprain?
Broadly, ankle sprains are classified into two:
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Inversion Sprain: It occurs when the foot is raised in a twisting motion, rolling the ankle inward.
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Eversion Sprain: It occurs when the deltoid ligaments are torn as the ankle rolls outward.
Based on the extent of damage to the ankles, sprains are classified as:
Grade 1 (Mild Impairment):
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Mild stretching and microscopic ligament fiber tearing.
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Mild ankle bruising, swelling, and tenderness.
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Usually, little discomfort when bearing weight.
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Examination revealed no instability.
Grade 2 (Moderate Impairment):
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Partial ligament tears.
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Moderate ankle bruising, edema (swelling), and pain.
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A slight ache when exerting weight.
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Examined little instability.
Grade 3 (Severe Impairment):
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Total ligament rupture.
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Significant ankle bruising, swelling, and tenderness.
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severe discomfort when carrying weight.
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On examination, there is significant instability.
After the acute injury phase has passed, the ankle may become fragile if the ligaments are completely torn. The bones and cartilage, the inner lining of the joint, may be harmed over time as a result of this instability.
What Are the Signs and Symptoms of Ankle Sprain?
Depending on the type and extent of the injury, the various signs and symptoms associated with ankle sprain include
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Ankle joint soreness on probing, pain, swelling, and limitations in range of motion are all symptoms, particularly when putting weight on the affected foot.
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Bruising, swelling, and tenderness to touch.
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Complaints of paresthesia or a chilly foot may indicate peroneal nerve neurovascular compromised function.
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History of ankle injuries or instability inversion, or severe eversion damage.
What Are the Diagnostic Guidelines for Ankle Sprain?
Since an ankle sprain affects several structures, a thorough evaluation of the foot and ankle is advised. When evaluating an injured ankle, it is important to note whether the patient has ever suffered from a similar injury. The following are the diagnostic parameters for ankle sprain:
1. Physical Examination:
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Observation: The doctor examines the sprained ankle and compares it with the other ankle to assess the extent of swelling or bruising. The patient is also observed for posture and to look for any deformities, alignment abnormalities, discoloration, or damage to the tissues.
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Palpation: Palpation with help understand the structures involved in the injury (bones or ligaments). It also aids in understanding and distinguishing these structures.
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Mobility Test: The patient will also be assessed for the ability to perform movement tasks to get an idea of the extent of injury or tear to the ankle.
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Stability Test: Stability testing may be carried out by pulling the ankle to assess the injury's severity and rule out the probability of ankle fractures.
2. Imaging Tests:
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X-ray: An ankle X-ray can assist medical professionals in determining the origin of ankle joint deformity, discomfort, soreness, and edema. This can aid in assessing whether a broken or dislocated joint. The doctor may also request a stress X-ray to determine how tightly the ligaments are holding the ankle together.
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Magnetic Resonance Imaging (MRI): MRI images of injured ligaments may show them to be attenuated, thickened, or disturbed. MRI images help identify injuries to the tendon, ligament, and cartilage. An ankle MRI can collect numerous cross-sectional images of the ankle and get a significantly more detailed image than an X-ray which aids in the diagnosis.
What Are the Treatment Guidelines for Ankle Sprain?
The treatment guidelines for sprained ankle include the following:
1. PRICE (Protection, Rest, Ice, Compression, and Elevation) Protocol: The PRICE regimen is used in the first treatment of ankle sprains. A reasonable strategy is to rest the injured ankle for the first 72 hours, then gradually resume activities as tolerated. An elastic bandage, any lace-up ankle support, a semi-rigid or inflatable brace, or an elastic bandage can all be used to apply compression. For the first 24 to 48 hours, elevating the damaged ankle above the heart level as often as possible may help reduce the swelling that comes with the injury.
2. Medications: Drugs belonging to the NSAID (non-steroidal anti-inflammatory agents) class and Acetaminophen may be employed to treat swelling, pain, and inflammation associated with the sprain.
3. Physical Therapy: Physical therapy is widely employed to improve patients' strength, flexibility, and balance during the later phases of recovery. The commonly employed methods include
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Mobility: The physician or physical therapist will recommend range-of-motion or controlled motions of the ankle without resistance to prevent stiffness.
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Exercising the Muscles: Exercises to strengthen the muscles and tendons in the front and rear of the leg and ankle will be added to the treatment plan once the pain and swelling have subsided.
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Exercises for Agility and Endurance: Other exercises like agility drills may be gradually added after pain-free. Running can be great for improving agility and calf and ankle strength. As balance improves with time, the aim is to gain strength and range of motion.
4. Surgical Intervention: Surgical repair has been recommended as a possible course of treatment for severe (grade III) acute ankle injuries. Chronic pain, functional instability, and resumption of pre-injury levels of sport involvement all benefited from surgery.
Conclusion:
Ankle sprains are common musculoskeletal injuries that are common among sportsmen and children. Prevention of such injuries through proper education will greatly reduce the incidence of sprains. Care should be taken to avoid further damage to the ligaments with adequate first-aid and treatment measures. Physical therapy and proper management options should be rightly adopted before returning to regular activities.
