An ankle sprain is a tear of one or more ligaments in the ankle. The most common type of ankle injury is an inversion ankle sprain which results in tearing of the ligaments on the outside of the ankle. When the ligaments don’t heal correctly, or they heal in a lengthened position, instability can result. In the past, the focus was on ligament damage in the ankle after a sprain, but new research has found that the leg muscles are also compromised. Researchers at Brigham Young University and University of Michigan evaluated muscle strength and response in 21 strong-ankled individuals and 21 weak-ankled individuals. The group with weak ankles had a history of prior ankle sprains and the strong-ankled group acted as the control group. The study participants walked down a runway hooked up to sensory equipment. The runway had doors built-in that would suddenly invert their ankle 30 degrees, enough to trigger muscle reaction and record the muscle response (particularly the peroneal muscles), but not enough to cause injury. They found that the muscles of the weak-ankled group had a slower response compared with the strong-ankled group. The muscles of the weak-ankled group also had less strength. The theory is that prior injuries leave muscle receptors with less sensitivity and this impairs their ability to react quickly and strongly. Further investigation on what factors contribute to ankle instability will help improve treatment and therapy.
Palmieri-Smith R et al. Peroneal Activation Deficits in Persons With Functional Ankle Instability. Am J Sports Med. 2009 May;37(5):982-8.
An ankle sprain is a tear of the ligaments in the ankle. The most common ligaments injured are on the outside of the ankle. This type of sprain is called an inversion ankle sprain and is shown in the picture to the right. Ankle sprains occur with simple activities like stepping off a curve or walking on uneven surfaces and are common in sporting activities like soccer, tennis, football, hiking and running.
The initial treatment for mild to moderate ankle sprains is very similar and the general guidelines involve an easy acronym. P – R – I – C – E – E
Protected walking: In the early stages of ankle sprains, when the ankle is still healing a lace-up ankle brace or air cast are a great way to support the ankle and allow for protected walking.
Rest: Resting is especially important in the first 2-3 days to allow for the swelling to go down.
Ice: Ice for 15-20 minutes every hour or two during the first 2-3 days.
Compression: An ace wrap compresses the ankle and controls swelling. Too much swelling increases pain and delays healing.
Elevation: Elevate the foot and ankle above the heart for the first 2-3 days after the sprain. Elevation helps keep the swelling and inflammation down.
Early Mobilization: After the first 2-3 days of rest, ice and elevation, range of motion exercises should be initiated.
Mild ankle sprains may only take a week or two for full recovery, but most ankle sprains will take about 6 weeks and full recovery may take up to three months. If you experience a severe ankle sprain, visit a podiatrist. If you have not healed from an ankle sprain after 6 weeks, make sure you see your doctor.