Sprains
An ankle sprain is an injury to one or more ligaments in the ankle. Ligaments are bands of tissue, like rubber bands, that connect one bone to another and bind the joints together. In the ankle joint, ligaments provide stability by limiting side-to-side movement. Most ankle sprains occur on the outer aspect of the ankle.
Some ankle sprains are worse than others. The severity of an ankle sprain depends on whether the ligament is partially or completely torn and on the number of ligaments involved. Ankle sprains are not the same as strains which affect muscles rather than ligaments. Medial, lateral, or a high ankle sprain will most likely be diagnosed depending where the pain is located.
Causes
- Walking or exercising on an uneven surface
- A fall
- Participating in a sport that requires a cutting action
- Twisting force to the lower leg
Ankle sprains are most commonly seen in an athlete or during recreational activities. All ages can be affected
Signs and Symptoms
- Swelling
- Bruising
- Inability to fully bear weight
- Tenderness to touch
- Instability feeling which may occur if there has been a complete ligament tear.
- A ‘pop’ may be heard if a ligament was torn.
Medial Ankle Sprain
- A medial ankle sprain occurs from excessive eversion or when the foot rolls outwards and causes damage to the deltoid ligament on the inside of the ankle joint.
Lateral Ankle Sprain
- A lateral ankle sprain occurs from excessive inversion or when the foot rolls inwards causing damage to the outside ankle joint ligaments.
High Ankle Sprain
- Occurs when the large ligament above the ankle joint that connects the two bones of the lower leg, tibia and fibula, together are pulled apart causing tearing.
- High ankle sprains tend not to heal as quickly.
Risk Factors
- Those with prior ankle sprains
- Participating in physical activity
- Wearing non-supportive shoes
Diagnosis
A physical exam will consist of the orthopaedic checking for any tender areas as well as looking at range of motion and strength.
Imaging test such as an X-ray or MRI will be ordered to determine if there is a fracture of the severity of any torn ligaments. Ultrasound may also be used while the doctor is moving your ankle to determine how much stability the ligament is providing.
The Doctor may diagnosis you with three different grades of an Ankle Sprain.
Grade I
- Mild ankle sprain
- Stretching of the ligaments and microscopic tearing of the ligament fibers
- Mild tenderness and swelling around the ankle jt
Grade II
- Partial tearing of a ligament
- Swelling and tenderness may be moderate
- Abnormal looseness of the ankle when ligaments are stress tested
Grade III
- Severe ankle sprain
- Significant tenderness and swelling
- Bruising
Treatment Options
- Non-Surgical Ankle Sprain and Fracture Treatment
- Surgical Ankle Sprain and Fracture Treatment
Prevention
- Strengthening exercises
- Calf raises
- Ankle 4-way tband
- Stretches
- Proper Shoewear
- Warm-up Properly before and after activity
- Pay attention to when walking, running or working on uneven surfaces.
Fractures
A fracture is a partial or complete break in a bone. In the ankle, fractures can range from the less-serious avulsion injuries (small pieces of bone that have been pulled off) to severe, shattering-type breaks of the tibia, fibula, or both.
Ankle fractures are common injuries that are most often caused by the ankle rolling inward or outward. Many people mistake an ankle fracture for an ankle sprain, but they are quite different and require an accurate and early diagnosis. Both can occur simultaneously.
Causes
- Rotating or twisting of the ankle
- Tripping, Falling or rolling your ankle
- Car Accident
Signs and Symptoms
- Pain at the site of the fracture that may be immediate and severe
- Significant swelling around the area or localized swelling over the fracture site
- Blisters may appear over the fracture site which need attention from a surgeon.
- Bruising
- Decreased or Inability to walk
Diagnosis
- Doctor physical exam to determine the extent of the injury
- Ask how the injury happened
- History of any prior injuries
- Symptoms of the injury
- X-rays
- Will show if the bone is broken or if there is a displacement between the bones.
Types of Common Ankle Fractures
- Lateral Malleolus Fracture: Break of the fibula which is the outside bone of the ankle.
- Medial Malleolus Fracture: Break in the tibia which is the inside bone of the lower leg and many times often occurs with a lateral, medial or posterior malleolus fracture. It also usually involves injury to ligaments as well.
- Posterior Malleolus Fracture:This is a fracture to the back of the tibia at the level of the ankle joint. Depending on the severity of the piece broken or size, this may be too unstable for the joint and require surgery.
- Bimalleolar Fracture: “Bi” meaning two, is when two out of the three malleoli are broken.
- Trimalleolar Fracture: “Tri” means that all 3 malleoli of the ankle are broken which causes usually causes an unstable ankle and can be associated with a dislocation.
