Ankle Sprain and the athlete: Read Part I

An ankle sprain is one of the most common injuries that sports fans hear about each season.  Some athletes are out a week or two and others are out for months  Fans start thinking a player is injury prone, soft, or some other misinformation simply because not all ankle sprains are created equal.

This post is going to be done in two separate parts to try to clarify the difference between a low or common ankle sprain and a high ankle sprain.  Hopefully, once you finish reading these posts, it will be a little easier to understand, especially before we start seeing news about ankle sprains occurring during training camp.

This type of ankle sprain is what most people have experienced at least once in their life. You step wrong, your foot comes down funky, and bam your ankle hurts and perhaps swells. 80% of all ankle sprains of this type are what is known as inversion sprains.

What does this mean? It means the foot and ankle are twisted in such a way that the bottom of the foot is facing the other leg rather than the ground.  This puts stress on the lateral ligaments of the ankle resulting in pain and swelling on the lateral (outside) of the ankle.

The other 20% of common ankle sprains result from eversion of the foot and ankle, which means the foot and ankle is twisted in such a way that the bottom of the foot is facing away from the other leg.  This motion puts stress on the medial ligaments of the ankle and results in pain and swelling in the medial (inside) of the ankle.

Low ankle sprains can occur for several reasons including walking or running on an uneven surface, falling down resulting in your body weight being unevenly distributed between your legs. It can also happen when participating in sporting activities which require rolling/twisting of the foot and ankle or rapid changes in direction and speed of the athlete.

Another way that an ankle gets sprained is when athletes are playing in close quarters with others and the athlete’s foot or ankle gets stepped or fallen on by someone else on the field.

Most ankle sprains of this type are minor and with simple treatment full function and a resolution of pain is possible in just a short time. These sprains are graded mild, moderate or severe, with most being mild or moderate in severity.
In a professional athlete, a mild sprain can often be treated simply by applying additional support through taping and the athlete can return to play.

Moderate and severe ankle sprains require more care to prevent the development of chronic instability and the risk for re-injury. Moderate and severe sprains are usually treated with braces/walking boots or short temporary casts to provide support during the initial recovery period to prevent further injury.

Treatment of common ankle sprains usually resolve with RICE. Not the stuff we eat, but Rest, Ice, Compression and Elevation.  The goal of treatment is to let the body heal the ligament damage itself and to maintain range of motion in the joint to decrease the chance of re-injury.

Most ankle sprains are better after 1-2 weeks and even the most severe ones that resulted from a complete tear of the ligaments in the ankle resolve with conservative therapy after 6-12 weeks.  Surgery is rarely needed to treat common ankle sprains and is only considered when pain and swelling have failed to resolve after months of conservative therapy.
Since I love analogies to everyday things when I am explaining medical problems to non-medical audiences, a common ankle sprain is a flat tire on your car.  As long as it is flat the car won’t roll.  Fix the flat and the car is as good as new.

In the next part of this ankle sprain discussion I will discuss high ankle sprains.  This is actually not an ankle injury despite the name and to use the car analogy again, this is like having a car with a busted axle. Not as easy to fix on your car or in an athlete. Stay tuned!

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