Ankle Sprains: The Good, The Bad, & The Ugly
by Dr. Nicholas Cheney
Ankle sprains are an extremely common injury sustained by athletes of all levels. It has been reported to be as high as 5 in every 10,000 high school athletes will unfortunately suffer an ankle sprain. Boys’ basketball seems to have the highest prevalence followed by football and girls’ basketball. While these injuries can be very painful and scary, very rarely does the injury turn out to be anything worse than a sprain. The old saying that is is better to break the ankle than sprain it is absolutely not true.
The ankle is a complex joint made up of three bones and multiple ligaments. The ligaments on the outside of the ankle are the ones that are damaged when the ankle is sprained.
- Ligaments attach bones to each other and prevent them from moving in certain directions.
- When the ankle is forced into an abnormal position, the ligaments can be damaged.
- The injury to the ligaments can range from being stretched to a partial tear up to a complete tear.
- The severity of the sprain is estimated by the amount of swelling and pain that the patient demonstrates on exam.
- X-rays are almost always obtained to rule out any significant fractures that may require more urgent treatment.
Once diagnosed with an ankle sprain, it is important to rest the ankle. Depending on the severity of the diagnosed sprain, this could mean being placed in a walking boot or a brace for support. During this period of rest, it is important to keep the ankle moving with range of motion exercises. The goal in the early rest and immobilization is to decrease swelling and inflammation and as a result decrease pain.
At the next physician appointment, it is important to re-evaluate the ankle as this is when is it best to identify the less common injuries that can be associated with an ankle sprain that may require more aggressive interventions. If something seems abnormal, an MRI could be beneficial to assist in diagnosing a more significant problem. If the patient has improved with the rest, it is then necessary to begin physical therapy to re-strengthen the muscles around the ankle joint in an effort to decrease the risks of spraining the ankle again due to residual weakness or instability. If the ankle is not adequately rehabbed, it can put the patient at risk for chronic ankle instability which can then become a surgical problem. The chronic instability can cause damage to the joint and that needs to be fixed to prevent early onset arthritis.
Dr. Cheney is a board-certified, fellowship-trained orthopedic surgeon who specializes in foot and ankle surgery. His practice emphasis includes ankle arthroplasty, heel pain, bunions, hammertoes, fractures, and foot/ankle sport injuries.
“The foot and ankle are complex structures that, when painful, can severely limit your quality of life. My goal is to help you understand both your diagnosis and treatment plan while guiding you in improving your quality of life. There is no greater professional reward than the smile and gratitude of a patient who I had the privilege to help feel better.”