Sprained Ankle: Causes, Symptoms, Risk Factors, Diagnosis, Treatment, Prevention and Complications

A sprained ankle is an injury caused by rolling, twisting, or turning your ankle awkwardly. This could lead to tearing or stretching of the strong tissue bands, or ligaments, that maintain the integrity of your ankle bones.

Ligaments restrict the range of motion of joints, which helps to stabilize them. Ankle sprains occur when the ligaments are stressed beyond their normal range of motion. Sprained ankles usually result in damage to the ligaments on the outside of the ankle.

The treatment for a sprained ankle depends on the severity of the injury. While self-care methods and over-the-counter medications could be enough, a medical checkup might be necessary to determine the best course of action and gauge the severity of your ankle sprain.

Causes Of Sprained Ankle

Sprains occur when one or more ligaments in your ankle are pulled out of its natural position. These tears can occur partially or completely.

The following conditions can cause a sprained ankle:

• A tumble that twists your ankle
• Stumbling into your foot after leaping or turning
• Anyone stepping on you or landing on your foot when you're playing sports; strolling or exercising on an uneven surface

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Symptoms Of Sprained Ankle

One can experience multiple indications and symptoms of a sprained ankle, depending on the extent of the injury. These might include:

• Ankle pain, especially when bearing weight on the affected foot
• Sensitivity to touch in the ankle 
• Bruising
• Swelling 
• Restricted movement 
• The ankle doesn't feel stable.
• Burst sound or sensation at the wound site

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Risk Factors Of Sprained Ankle

The following factors increase your risk of having a sprained ankle:

• Involvement in sports: Sports injuries such as ankle sprains are frequent, particularly in sports like trail running, basketball, tennis, football, and soccer where players must jump, cut, roll, or twist their feet.
• Uneven surfaces: When walking or running on uneven ground or in poor field conditions, an ankle sprain may occur more frequently.
• Previous ankle injury: If you have previously sprained your ankle or have experienced another type of ankle injury, you run the chance of doing so again.
• Insufficient physical condition: If your ankles are weak or flexible, you run a higher chance of spraining them while playing sports.
• Inappropriate footwear: People who wear high-heeled shoes or shoes that are poorly fitting or inappropriate for the activity are more likely to sustain an ankle injury.

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Diagnosis Of Sprained Ankle

During a physical exam, your doctor will assess your foot, ankle, and lower leg. Your foot will be moved by the doctor to evaluate your range of motion and identify any painful or uncomfortable situations. To feel for any sore regions, they will also touch the area surrounding the injury.

If the injury is severe, your doctor may recommend one or more of the following imaging procedures to rule out a broken bone or more accurately determine the level of ligament damage:

• X-ray: During an X-ray, a very small amount of radiation passes through your body to produce images of your ankle bones. This test can be used to rule out bone fractures.
• Magnetic resonance imaging (MRI): Magnetic resonance imaging (MRI) produces highly detailed 3-D or cross-sectional images of the soft internal ankle structures, such as ligaments, using radio waves and a strong magnetic field.
• CT scan: CT scans can give more detailed information about the bones in the joint. By integrating X-rays acquired from different angles, a CT scan can provide three-dimensional or cross-sectional images.
• Ultrasound: Using sound waves, ultrasound produces images in real-time. With the foot in different positions, these images may help your doctor assess the condition of a tendon or ligament.

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Treatment Of Sprained Ankle

The course of treatment for a sprained ankle depends on the severity of the injury. The goals of treatment are to minimize pain and edema, hasten ligament recovery, and restore ankle function. Should your injuries be severe, you may be referred to a physical medicine and rehabilitation specialist or an orthopedic surgeon, who are experts in treating musculoskeletal issues.

Using the R.I.C.E. approach, take care of yourself during the first two or three days after spraining your ankle:

• Relax: Avoid doing things that make you feel more pain, edema, or discomfort.
• Ice: Apply an ice pack or take an ice bath for 15 to 20 minutes as soon as you wake up. Every two to three hours, repeat. Consult your physician before utilizing ice if you suffer from diabetes, circulatory issues, or reduced sensation.
• Compression: Squeeze the ankle with an elastic bandage until the swelling goes down. Avoid wrapping too tightly as this may prevent blood flow. Wrap beginning at the end that is farthest from your heart.
• Increase in altitude: If possible, try raising your ankle over your heart to reduce swelling, especially during the night. Extra fluid is drained by gravity, which reduces swelling.

Medications

Most of the time, over-the-counter analgesics such as ibuprofen (Advil, Motrin IB, etc.), naproxen sodium (Aleve, etc.), or acetaminophen (Tylenol, etc.) are effective in treating sprained ankle discomfort.

Equipment

If you have a sprained ankle, you may need to use crutches until the pain subsides as walking may be painful. Depending on how bad your sprain is, your doctor might suggest using athletic tape, an ankle support brace, or an elastic bandage to stabilize your ankle. If the sprain is severe, you may need to cast or wear a walking boot to immobilize the ankle until it heals.

Therapy

Once your swelling and pain are sufficiently decreased to allow you to resume your typical activities, your doctor will have you begin an exercise plan designed to restore your ankle's strength, flexibility, range of motion, and stability. Your doctor or physical therapist will go over the proper technique and progression of your workout.

Balance and stability training is very important to teach the ankle muscles to work together to support the joint and help prevent recurrent sprains. These actions, such as standing on one leg, can make balancing difficult to varied degrees.

If you hurt your ankle playing sports or working out, find out when you can resume your activities by speaking with your doctor. If you participate in sports, your physician or physical therapist may ask you to perform particular movement and activity tests in order to evaluate how well your ankle functions.

Surgery

Surgery may be required in certain cases if the damage does not heal or if the ankle does not stabilize after a lengthy period of physical therapy and rehabilitation exercises. Surgery could be performed in order to:

• Repair a ligament that is not healing properly.
• Rebuild a ligament with tissue taken from an adjacent tendon or ligament.

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Prevention Of Sprained Ankle

Applying the following tips will help you prevent getting a sprained ankle or recurring sprain:

• Warm up before engaging in any physical activity.
• Use caution when walking, jogging, or working on uneven ground.
• Tape or an ankle support device should be used to treat a weak or previously injured ankle.
• Put on shoes that fit well and are suitable for the activity.
• Don't wear as many high-heeled shoes.
• Refrain from playing sports or partaking in other unprepared activities.
• Retain your muscles' strength and flexibility.
• Exercise for stability should involve balancing drills.

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Complications Of Sprained Ankle

The following outcomes could occur from treating a sprained ankle incorrectly, spraining it frequently, or engaging in activities too soon after the injury:

• Continuous pain in the ankles
• Prolonged ankle joint instability 
• Ankle joint arthritis

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