Steven M. Erickson, MD, FACP, is board certified in both internal medicine and sports medicine. He serves as medical director of the Banner Concussion Center, which operates the Banner Health Clinic specializing in sports medicine. His office can be reached at (602) 839-7285.
Question: Ankle sprains are common in sports medicine. How can ankle sprains be prevented and when should you seek medical care for a sprain?
Answer: A typical lateral ankle sprain results when one or more of the three ligaments that stabilize the ankle bones and joint is stretched beyond its limits. Like the pain they inflict, ankle sprains can range from mild, to moderate, to severe.
A mild sprain typically occurs when a person twists his or her ankle, but is able to walk off the pain and resume activity shortly thereafter with little to no swelling in the coming days. In such cases, the ligament was stretched, but did not tear or cause structural damage. Moderate sprains, which may entail some tearing of the ligament, often are accompanied by swelling, decreased range of motion and instability of the ankle. Severe ankle sprains include the partial or complete tearing of one or more ligaments, resulting in immediate swelling and an inability to walk.
When treated appropriately, an ankle sprain, even a severe one, usually can heal on its own. However, severe and even some moderate sprains may overstretch the ligaments to the point that they will never be as tight as they once were. Sometimes described as being “loose,” the ankle is more susceptible to future injury since the ligaments no longer hold and stabilize the ankle bones and joints as tightly as they once did.
Guidelines for treating an ankle sprain vary based on age and symptoms. Anyone younger than 10 or over the age of 65 should be seen by a medical professional for evaluation and treatment. Open growth plates in children and brittle bones in older adults increase the risk of further injury. Guidelines for the rest of the population are based on symptoms. Walking with a limp, inability to bear weight on the foot/ankle, and swelling or pain a week or so after injury indicate a need to be evaluated.
During the evaluation, the clinician will be able to determine whether a ligament was in fact torn, asses how loose the ankle is, evaluate the state of the tendons supporting the ankle and confirm if a fracture was sustained as part of the sprain. A severe ankle sprain that did not include a fracture may require immobilization for a period of time followed by physical therapy to regain range of motion and slowly allow the ankle to once again bear weight. If a fracture did in fact occur, a cast or even surgery may be necessary.
Of course, prevention is the best treatment. Thoroughly stretch before beginning any sort of physical activity, wear appropriate footwear for the sport or activity, and slowly increase your running distance or workout intensity to help strengthen the tendons and ligaments around your ankles. Athletic trainers and physical therapists can outline specific exercises to help athletes prevent ankle sprains.
More information about ankle sprains and how to prevent them can be found on the American Medical Society for Sports Medicine website, www.amssm.org, as well as the Banner Health website at www.BannerHealth.com.