Ankle Sprain

From Economou SG, Economou TS: Instructions for Surgery Patients.
Philadelphia, WB Saunders, 1998, p. 41.

Description
An acute ankle sprain involves the stretching and tearing of one or more ligaments in the ankle. A two-ligament sprain causes more disability than a single-ligament sprain. Sprains are classified into three grades: In a first-degree sprain, the ligament is not stretched or lengthened but is painful. With a second-degree sprain, the ligament is stretched but still functions. With a third-degree sprain, the ligament is torn and does not function.
Lateral ankle sprains: There are three ligaments of the outer (lateral) ankle. These are the most common sprains.

Medial ankle sprains: There is one large triangular ligament of the inner (medial) ankle, which is stronger and more compact than the outer ligaments, making injuries to it less likely.

Syndesmosis (“high ankle”) sprains: This is the ligament that connects the two leg bones just above the ankle. This ligament is usually injured when the sprain to the ankle is very severe.

Common Signs and Symptoms – Notify a physician if these symptoms do not resolve within 72 hours:

Pain, tenderness, and swelling in the ankle, starting at the side of injury, that may progress to the whole ankle and foot with time
Pop or tearing sensation at the time of injury · Bruising that may spread to the heel
Impaired ability to walk soon after injury

Treatment
Initial treatment consists of ice to relieve the pain and compressive elastic bandage and elevation to help reduce swelling and discomfort. A walking cast, walking boot, or brace may be recommended to provide support to the joint while trying to walk with crutches for varying lengths of time, depending on the severity of injury. Surgical treatment is rarely necessary. After the inflammation and pain are reduced, regaining motion, strength, and balance in the ankle is important to return to full capacity and to reduce recurrent injury.

RICE Principle
With all acute injuries, follow the RICE principle to reduce swelling, pain and inflammation.

Rest- Walk with crutches if you cannot bear weight.
Ice- Use an ice pack for 20 minutes every two to three hours during the first 72 hours.
Compression- Use an ace wrap on the ankle. Start at the bottom of the toes and wrap up to mid-calf.
Elevation- Keep the injured ankle above the level of your heart when sitting or lying down