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Ankle Sprain

Are you an avid runner, hiker or bicyclist? Then, chances are you have suffered at least one ankle sprain in your lifetime. An ankle sprain is an inadvertent over-lengthening and sometimes tearing of the ligaments of the ankle leading to inflammation, pain and instability while walking. Ankle sprains are graded from minor (Grade 1) to most severe (Grade 3). Literature varies on the most common age group affected by ankle sprains as they have been well documented in small children (ligamentously lax) as well as in the aging population (prone to more unstable gait). As with most lower extremity injuries the “weekend warriors” are usually a very commonly effected group. We at Union County Orthopaedic Group are happy to guide you through the diagnosis and treatment of your ankle sprain. Our office prides itself on kind, efficient and quality service; including the handling of insurance, scheduling and follow-up care.

 Anatomy of the Ankle

The ankle joint is a complex and significant joint in our ability to walk and run. Its 3 main components include the tibia and fibula (leg bones) and the talus (foot bone). Surrounding these three bones is a capsule, numerous ligaments and tendons that all help to create a dynamic yet stable ankle structure. The ankle joint, like many other joints in the body has a ball and socket “like appearance” that is formed by the lower end of the leg (tibia and fibula) with the dome-shaped talus foot bone. The talus is of vital importance because not only does it help form the ankle joint but also it serves as the connection point of the leg to the foot. The bottom of the talus sits on top of the calcaneus (bone of the heel).

 Risk Factors for Injury 

Ankle sprains are caused by a variety of factors. Often sports related activities are to blame for this condition. However other risk factors include:

  • Previous Ankle Sprain: A common predictor of an ankle sprain is a previous ankle sprain.
  • Sex: Slight predominance in females as they often are more ligamentously lax then their male counterparts.
  • Biomechanical: weak, or over-stretched ankle ligaments, patients with higher arch feet, unstable gait.
  • Physical Activity: poor technique in sports activities can cause this condition (improper heel strike). Uneven ground or terrain is one of the most common causes of ankle sprain, however inappropriate or improper shoes can also contribute.
  • Medical History: People with a medical history that includes rheumatoid arthritis, psoriasis, and connective tissue disorders
  • Medications: Certain types of antibiotics can have tendon damaging side effects. A special group of antibiotics called fluoroquinolones have been associated with higher rates of ligament instability and tear, including in the ankle.

Symptoms of Ankle Sprain

The symptoms of an ankle sprain can vary from patient to patient but there are always signs to be aware of. Most patients can recall a specific incident; trip or fall or misstep during an activity. During the first 24-48 hours you will often experience pain, inflammation, swelling and sometimes bruising. Bearing direct weight or pressure on the ankle may be difficult. The higher the grade of ankle sprain the more difficult it will be for you to place weight on the ankle. The pain can radiate down to the level of the foot or travel up the leg. Anytime an ankle sprain is suspected or diagnosed it is imperative to obtain radiographic images of the ankle to ensure that an ankle or foot fracture (a more serious condition) is not present.

Diagnosis of Ankle Sprain

The most important first step in diagnosing and treating an ankle sprain is to make an appointment with your knowledgeable Union County Orthopaedic Group physicians. Our staff and facilities are well equipped to identify this condition and find the most effective and appropriate treatments for you.

Your Union County Orthopaedic Group physician will look for a specific set of physical and imaging findings including:

  • Swelling, bruising or inappropriate laxity in the ligaments of the ankle. Most commonly an “Anterior Drawer” and “Lachman” test will be performed. These are simple, non-invasive tests that can provide your physician a wealth of knowledge about your condition.
  • Identify the point of maximum tenderness and ensure this point does not correspond with an underlying fracture.
  • Assess the ankle joint range of motion to determine is a period of immobilization is required.
  • Imaging modalities such as X-ray, MRI, CT, stress-tenogram and ankle arthroscopy are all useful in the diagnosis of an ankle sprain.

Treatment of Ankle Sprain

Most patients will have relief of pain and return to normal daily and sports activities with nonsurgical treatment options. Treatment options often range from conservative (non-surgical) to invasive surgical intervention. Surgical intervention is usually used for severe grade ankle sprains, significant ligament tears or for ankle instability as a result of chronic or repeated ankle sprains.

Conservative:

  • RICE – rest, ice, compression, elevation
  • Immobilization in cast or boot – allows the ligaments a chance to heal
  • Non-steroidal anti-inflammatory medication
  • Exercise, stretching, and physical therapy
  • Anti-inflammatory steroid injections
  • Bracing: which is specialized to sit at the ankle joint and prevent side-to-side sway or instability at the ankle joint.

The first step in treatment of an ankle sprain is a proper diagnosis. One visit with a Union County Orthopaedic Group physician can make all the difference in your ability to get back to the activities you love faster and without pain. Proper treatment of an ankle sprain is vital in preventing future injury and instability and can ward off more serious ankle injuries like ankle fracture.