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Todd Borenstein MD

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Ankle Sprain

Ankle sprains are common injuries that occur from stretching or tearing of the ankle ligaments, the strong bands of tissue that support the bones of the ankle.

What causes an ankle sprain?

The ligaments of the ankle function to prevent abnormal movement such as twisting or rolling beyond the normal range of motion. Sprains may result from a sports injury or stepping on uneven surface while running or walking. A sudden inversion, or inward movement of the ankle beyond the normal range can then result in an ankle sprain.

What are the symptoms of an ankle sprain?

Symptoms include pain, swelling, bruising and stiffness of the ankle.

How is an ankle sprain diagnosed?

Ankle sprains are diagnosed with medical history, physical examination, and with X-rays to assess for the presence of a fracture. MRI’s may be ordered to better assess the torn ligament in some cases.

How are ankle sprains treated?

Nonoperative management

All ankle sprains are initially treated with the R.I.C.E. method: Rest, Ice, Compression, Elevation. The duration of R.I.C.E typically lasts 1-2 weeks, depending on the grade of the sprain. Higher grade sprains are often immobilized in a boot or short leg cast to allow for healing of the ligaments.

Patients will often take anti-inflammatory medications to decrease swelling and pain,

Physical therapy is often prescribed to increase the rate of recovery by increasing ankle strength, range of motion, and proprioceptive (balance) training. This can also prevent chronic foot and ankle problems by avoiding an altered or compensatory gait pattern.

Operative management

Patients with a grade 3 ankle sprain will occasionally continue to have pain, or instability of the ankle after months of healing time and conservative treatment.

These patients can benefit from ankle arthroscopy to inspect the ankle joint and to repair the torn ligaments. Ankle arthroscopy is a surgical procedure where a small camera and instruments, roughly the size of a pencil, are inserted into the joint through small incisions to remove inflamed tissue, bone spurs, and loose pieces of bone and cartilage.