Ankle Sprain
Also known as: Ankle ligament sprain, Sprained ankle, Lateral ankle sprain, Inversion ankle sprain, ATFL sprain, Twisted ankle, Rolled ankle
Last updated: December 18, 2024
Ankle sprain is an injury to the ligaments that support the ankle joint, often occurring when the foot twists or rolls beyond its normal range of motion. The outside (lateral) ligaments are most often affected, especially the anterior talofibular ligament, and sprains range from mild stretching to complete tears. Symptoms include pain, swelling, and bruising. Treatment may begin with RICE, and most heal well.
Key Facts
- •An ankle sprain is an injury to the ligaments that support the ankle joint, occurring when the foot twists or rolls beyond its normal range of motion
- •Pain at the time of injury, with a popping or tearing sensation
- •Diagnosed through history, physical exam, and imaging
- •First-line treatment includes exercise, weight management, and activity modification
What It Is
An ankle sprain is an injury to the ligaments that support the ankle joint, typically occurring when the foot twists or rolls beyond its normal range of motion. The lateral (outside) ligaments are most commonly affected, particularly the anterior talofibular ligament. Sprains are graded based on severity from mild stretching to complete ligament tears.
Affected Anatomy
This condition affects several structures in and around the joint:
- •Anterior talofibular ligament (ATFL, most commonly injured)
- •Calcaneofibular ligament (CFL)
- •Posterior talofibular ligament (PTFL)
- •Deltoid ligament (medial side, less commonly injured)
- •Ankle joint capsule
- •Surrounding muscles and tendons including peroneal tendons
Common Symptoms
Symptoms can vary in intensity and may change over time. Common experiences include:
- •Pain at the time of injury, often with a popping or tearing sensation
- •Swelling around the ankle, often developing rapidly
- •Bruising that may appear over hours to days
- •Tenderness when touching the injured area
- •Difficulty bearing weight on the affected foot
- •Instability or feeling that the ankle gives way
- •Limited range of motion due to pain and swelling
- •Stiffness after periods of rest
Causes and Risk Factors
Multiple factors can contribute to the development of this condition:
Causes
- •Rolling or twisting the ankle inward (inversion, most common)
- •Rolling the ankle outward (eversion, less common but often more severe)
- •Landing awkwardly from a jump
- •Walking or running on uneven surfaces
- •Sports involving cutting, pivoting, or rapid direction changes
- •Direct impact or trauma to the ankle
Risk Factors
- •Previous ankle sprain (strongest risk factor for recurrence)
- •Participation in sports such as basketball, soccer, volleyball, and running
- •Walking or exercising on uneven terrain
- •Poor ankle strength or proprioception
- •Inadequate warm-up before physical activity
- •Improper or worn footwear
- •Anatomical factors such as high arches or ankle instability
How It's Diagnosed
Diagnosis typically involves a combination of clinical assessment and imaging studies:
- •Medical history focusing on mechanism of injury and previous ankle problems
- •Physical examination including palpation, range of motion, and stability testing
- •Anterior drawer test and talar tilt test to assess ligament integrity
- •Ottawa Ankle Rules to determine need for X-rays
- •X-rays to rule out fractures when indicated
- •MRI may be used if significant ligament injury or associated pathology is suspected
- •Stress radiographs may be used to assess instability in chronic cases
Treatment Options
Treatment approaches range from conservative measures to surgical interventions, often starting with the least invasive options:
Self-Care and Activity Modification
- •RICE protocol (rest, ice, compression, elevation) in the acute phase
- •Protected weight bearing with crutches if needed
- •Ankle bracing or taping for support during healing
- •Gradual return to activity with attention to ankle support
- •Balance and coordination exercises to reduce recurrence risk
Physical Therapy and Exercise
- •Physical therapy for range of motion, strengthening, and proprioceptive training
Medications
- •NSAIDs for pain and inflammation
Surgery
- •Surgical ligament repair or reconstruction may be considered for chronic instability after failed conservative treatment
Prognosis and Recovery
The course of this condition varies between individuals:
- •Most ankle sprains heal well with appropriate conservative treatment
- •Mild sprains (Grade I) may recover in 1 to 3 weeks
- •Moderate to severe sprains (Grade II-III) may require 6 to 12 weeks for recovery
- •Risk of re-injury is significant without proper rehabilitation
- •Chronic ankle instability may develop in 10-30% of patients
- •Early mobilization and rehabilitation improve outcomes compared to immobilization
Related Pages
- Ankle Arthroscopy(Procedure)
- Achilles Tendinitis (Achilles Tendinopathy)(Condition)