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A sprained ankle is a very common injury. Approximately 25,000 people experience it each day. A sprained ankle can happen to athletes and non-athletes, children and adults. It can happen when you take part in sports and physical fitness activities. It can also happen when you simply step on an uneven surface, or step down at an angle.

The ligaments of the ankle hold the ankle bones and joint in position. They protect the ankle joint from abnormal movements-especially twisting, turning, and rolling of the foot.

A ligament is an elastic structure. Ligaments usually stretch within their limits, and then go back to their normal positions. When a ligament is forced to stretch beyond its normal range, a sprain occurs. A severe sprain causes actual tearing of the elastic fibers.How It Happens

Ankle sprains happen when the foot twists, rolls or turns beyond its normal motions. A great force is transmitted upon landing. You can sprain your ankle if the foot is planted unevenly on a surface, beyond the normal force of stepping. This causes the ligaments to stretch beyond their normal range in an abnormal position.Top of page

Mechanism of Injury

If there is a severe in-turning or out-turning of the foot relative to the ankle, the forces cause the ligaments to stretch beyond their normal length. If the force is too strong, the ligaments can tear. You may lose your balance when your foot is placed unevenly on the ground. You may fall and be unable to stand on that foot. When excessive force is applied to the ankle's soft tissue structures, you may even hear a "pop". Pain and swelling result.

The amount of force determines the grade of the sprain. A mild sprain is a Grade 1. A moderate sprain is a Grade 2. A severe strain is a Grade 3 (see Table below).

  • Grade 1 sprain:

    Slight stretching and some damage to the fibers (fibrils) of the ligament.

  • Grade 2 sprain:

    Partial tearing of the ligament. If the ankle joint is examined and moved in certain ways, abnormal looseness (laxity) of the ankle joint occurs.

  • Grade 3 sprain:

    Complete tear of the ligament. If the examiner pulls or pushes on the ankle joint in certain movements, gross instability occurs.

Classification of Ankle Sprains

SeverityPhysical

Examination

Findings

Impairment

Pathophysiology

Typical Treatment*Grade 1

Minimal tenderness and swelling

Minimal

Microscopic tearing of collagen fibers

Weight bearing as tolerated

No splinting/casting

Isometric exercises

Full range-of-motion and stretching/ strengthening exercises as tolerated

Grade 2

Moderated tenderness and swelling

Decreased range of motion

Possible instability

Moderated

Complete tears of some but not all collagen fibers in the ligament

Immobilization with air splint

Physical therapy with range-of-motion and stretching/ strengthening exercises

Grade 3

Significant swelling and tenderness

Instability

Severe

Complete tear/ rupture of ligament

Immobilization

Physical therapy similar to that for grade 2 sprains but over a longer period

Possible surgical reconstruction

Top of page

Diagnosis

See your doctor to diagnose a sprained ankle. He or she may order X-rays to make sure you don't have a broken bone in the ankle or foot. A broken bone can have similar symptoms of pain and swelling.

The injured ligament may feel tender. If there is no broken bone, the doctor may be able to tell you the grade of your ankle sprain based upon the amount of swelling, pain and bruising.

The physical exam may be painful. The doctor may need to move your ankle in various ways to see which ligament has been hurt or torn.

If there is a complete tear of the ligaments, the ankle may become unstable after the initial injury phase passes. If this occurs, it is possible that the injury may also cause damage to the ankle joint surface itself.

The doctor may order an MRI (magnetic resonance imaging) scan if he or she suspects a very severe injury to the ligaments, injury to the joint surface, a small bone chip or other problem. The MRI can make sure the diagnosis is correct. The MRI may be ordered after the period of swelling and bruising resolves.Top of page

Symptoms

The amount of pain depends on the amount of stretching and tearing of the ligament. Instability occurs when there has been complete tearing of the ligament or a complete dislocation of the ankle joint.Top of page

Treatment

Nonsurgical Treatment

Walking may be difficult because of the swelling and pain. You may need to use crutches if walking causes pain. Usually swelling and pain will last two days to three days. Depending upon the grade of injury, the doctor may tell you to use removable plastic devices such as castboots or air splints.

Most ankle sprains need only a period of protection to heal. The healing process takes about four weeks to six weeks. The doctor may tell you to incorporate motion early in the healing process to prevent stiffness. Motion may also aid in being able to sense position, location, orientation and movement of the ankle (proprioception). Even a complete ligament tear can heal without surgical repair if it is immobilized appropriately. Even if an ankle has a chronic tear, it can still be highly functional because overlying tendons help with stability and motion.

For a Grade 1 sprain, use R.I.C.E (rest, ice, compression and elevation):

  • Rest your ankle by not walking on it.
  • Ice should be immediately applied. It keeps the swelling down. It can be used for 20 minutes to 30 minutes, three or four times daily. Combine ice with wrapping to decrease swelling, pain and dysfunction.
  • Compression dressings, bandages or ace-wraps immobilize and support the injured ankle.
  • Elevate your ankle above your heart level for 48 hours.

For a Grade 2 sprain, the RICE guidelines can also be used. Allow more time for healing to occur. The doctor may also use a device to immobilize or splint the ankle.

A Grade 3 sprain can be associated with permanent instability. Surgery is rarely needed. A short leg cast or a cast-brace may be used for two weeks to three weeks.

Rehabilitation is used to help to decrease pain and swelling and to prevent chronic ankle problems. Ultrasound and electrical stimulation may also be used as needed to help with pain and swelling. At first, rehabilitation exercises may involve active range of motion or controlled movements of the ankle joint without resistance. Water exercises may be used if land-based strengthening exercises, such as toe-raising, are too painful. Lower extremity exercises and endurance activities are added as tolerated. Proprioception training is very important, as poor propriception is a major cause of repeat sprain and an unstable ankle joint. Once you are pain-free, other exercises may be added, such as agility drills. The goal is to increase strength and range of motion as balance improves over time.

All ankle sprains recover through three phases:

  • Phase 1 includes resting, protecting the ankle and reducing the swelling (one week).
  • Phase 2 includes restoring range of motion, strength and flexibility (one week to two weeks).
  • Phase 3 includes gradually returning to activities that do not require turning or twisting the ankle and doing maintenance exercises. This will be followed later by being able to do activities that require sharp, sudden turns (cutting activities) such as tennis, Basketball or football (weeks to months).

Medication

Nonsteroidal anti-inflammatory drugs (NSAIDs) may be used to control pain and inflammation.

Long-term outcome

If an ankle sprain is not recognized, and is not treated with the necessary attention and care, chronic problems of pain and instability may result.

Surgical Treatment

Surgical treatment for ankle sprains is rare. Surgery is reserved for injuries that fail to respond to nonsurgical treatment, and for persistent instability after months of rehabilitation and non-surgical treatment.

Surgical options include:

  • Arthroscopy

    A surgeon looks inside the joint to see if there are any loose fragments of bone or cartilage, or part of the ligament caught in the joint.

  • Reconstruction

    A surgeon repairs the torn ligament with stitches or suture, or uses other ligaments and/or tendons found in the foot and around the ankle to repair the damaged ligaments.

Top of page

Rehabilitation

Rehabilitation after surgery involves time and attention to restore strength and range of motion so you can return to pre-injury function. The length of time you can expect to spend recovering depends upon the extent of injury and the amount of surgery that was done. Rehabilitation may take from weeks to months.Top of page

Prevention

The best way to prevent ankle sprains is to maintain good strength, muscle balance and flexibility.

  • Warm-up before doing exercises and vigorous activities
  • Pay attention to walking, running or working surfaces
  • Wear good shoes
  • Pay attention to your body's warning signs to slow down when you feel pain or fatigue
Top of page

Is It Acute or Chronic?

If you have sprained your ankle in the past, you may continue to sprain it if the ligaments did not have time to completely heal. If the sprain happens frequently and pain continues for more than four weeks to six weeks, you may have a chronic ankle sprain. Activities that tend to make an already sprained ankle worse include stepping on uneven surfaces, cutting actions and sports that require rolling or twisting of the foot, such as trail running, basketball, tennis, football and soccer.

Possible complications of ankle sprains and treatment include abnormal proprioception. There may be imbalance and muscle weakness that causes a re-injury. If this happens over and over again, a chronic situation may persist with instability, a sense of the ankle giving way (gross laxity) and chronic pain. This can also happen if you return to work, sports or other activities without letting the ankle heal and become rehabilitated.Top of page

Last reviewed and updated: March 2005


how to spang your ankel

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9y ago
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9y ago

First, you should be sure the finger is just sprained and not broken. If it's a sprain you can put it in a finger splint. A variety of finger splints can be found at the drugstore or you can use a popsicle stick. Tape the stick to your finger in a couple of places. Another way is to tape it to the adjacent finger (called a buddy-spint) for a short time. So long as there was no fracture or dislocation, you should start moving a finger sprain in about a week. Splinting the sprained finger can protect the injury, but unnecessarily splinting a finger cause cause it to stiffen.
Go to the doctor

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13y ago

First you start of by hitting your arm on a pole or wall or something like that. Then you put ice cold water on top of it for 10 seconds then it should be sprained!

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12y ago

well you can fall down the stairs or you can fall and cause you ankle to bend and then you will sprain it but take pain killer sfirst to avoid pain although alot of pain s not involved

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12y ago

You play Rugby

You hold it out and have someone kick up directly at it; it happened to me as an accident and it HURT.

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12y ago

hold it with the other hand and secure your arm down and the twist your hand round it does really work

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12y ago

You can do this thing called buddy taping which is where you tape your sprained finger to the one next to it, this helps to keep the finger still while it heals.

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Q: What do you do if you have a sprained finger?
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Related questions

Should you tape your sprained finger?

yes


Can a splint be used for a sprained pinky finger?

sure


What medicine to take for sprained finger?

There is no medication for a sprain. Put ice on it.


How does the palm of your hand get bruised?

i fell and landed on my hand and i think i sprained my little finger


What happens when you traumatize your finger?

Depending on how hard you "traumatize" it. Your finger could be anywhere from bruised to sprained to broken to dislocated. To traumatize is to cause damage to.


Where do sprains Occur?

Any ligament can be sprained, but the most frequently injured ligaments are at the ankle, knee, and finger joints.


Should you see a doctor if you have a sprained finger?

It may not be a sprain even if you think it is. I thought I sprained my right middle finger but it was swollen and hurt for 2 months so I went to the orthopedic doctor and it turned out that I tore a ligament. I'm still recovering so I would suggest that you get it checked, just in case.


Where do sprains normally occur?

Any ligament can be sprained, but the most frequently injured ligaments are at the ankle, knee, and finger joints.


I was with friends at the local hills I fell half down and I mustve landed awkwardly as whenever I bend my little finger it hurts slightly but what is it my finger hurts and I dont know what to do?

Go to the hospital you might have a sprained finger (if it is grey/blue) or you have a broken bone


What should you do for a sprained pinkie?

Make sure you keep it raised, do not put pressure on it, and be careful. Ask you doctor about a finger metal cast with padding.


What is the difference between 'wounded' and 'injured'?

A wound is a kind of injury, one generally involving broken skin. Thus a sprained ankle and a cut finger are both injuries, but only the cut finger would be called a wound.


Pain in left middle finger?

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