Ankle Sprain: Diagnosis and Treatment

Ankle sprain is a very common injury. It is caused by a rotatory or twisting force acting on the ankle joint. It is seen in sports injuries, traffic accidents, jumping, stepping in to a hole or slipping off a step.

Before reading further it would first be good to know the relevant ankle anatomy. (skip this it you have already read the page)

The sprain results in stretching or tearing of the ligaments of the ankle joint.

Sprain of the lateral ligament of ankle is more common than the medial ligament.

Symptoms include

  • history of injury
  • pain over the ankle
  • Swelling
  • difficulty in walking
  • reddish bluish discolouration
  • a sensation of a snap in the ankle joint
  • tenderness is present

Diagnosis is by clinical history and examination. During examination your doctor may manipulate your ankle in different positions and compare with the opposite side to check for any abnormal mobility of the ankle joint. This is called a stress test.

It helps the doctor to determine the grade or degree of ligament injury. X rays taken during the above manipulation are called stress x rays and they too help to ascertain the degree of injury. X rays also help to rule out fractures.

MRI scan of the ankle may also be required.

Sprains are classified on the degree of tear of the ligament

  • Degree 1 is stretching of the ligament
  • Degree 2 is partial tear of the ligament
  • Degree 3 is complete tear of the ligament

Treatment for degree 1 and 2 includes

  • use of ice
  • rest to the involved limb by restriction of activity
  • use of a crepe bandage or splint
  • anti-inflammatory medication
  • physiotherapy after pain has completely subsided

Treatment of degree 3 injuries includes the above methods along with immobilization of the ankle in a plaster cast for 6 to 8 weeks. Physiotherapy is started after cast removal.

Complications include

  • osteochondral fracture
  • chronic instability or weakness of the ankle joint

Frequently Asked Questions

As symptoms of ankle sprain and fracture are more or less the same how can they be differentiated?

The best way to differentiate between a sprain and a fracture is by a x ray of the ankle. Without a x ray a fracture will have more

  • obvious deformity
  • swelling
  • reddish bluish discoloration
  • pain and tenderness
  • difficulty or inability to walk

There is a common myth that if you have a fracture you will not be able to move your toes. Inability to move the toes will be present only when the fracture is in the bones of the toe. So in fracture or sprain of the ankle you will be able to move your toes.

How is chronic instability of the ankle treated?

Chronic instability occurs after a degree 3 sprain or repeated injury to the ligaments and is treated by reconstruction of the ligament from tendon or fascia.

I hope the information provided was helpful. If you have any query you can ask me at the contact me page.

This page was last updated on 2nd March 2009.

Other causes of ankle pain ...

Ankle Fracture

Ankle Arthritis

Pilon Fracture

Tillaux Fracture

Ankle Dislocation

Go back from Ankle Sprain to Ankle Pain


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