Sprained Ankle: symptoms and treatment options

Updated 2/22/2019
Dr. Baravarian discusses ankle sprains and why not ignore them.

Ankle sprains often while participating in sports, walking on uneven surfaces, or just awkwardly planting the foot.


A sprain is an acute injury that can happen in the blink of an eye, and typically occurs when the foot is twisted or turned out of its normal range of motion. 


The most frequent type of sprain is called an inversion sprain, which is when the outer ligaments stretch or tear when the foot is rolled outward, with the sole facing in. Less common is a medial sprain, which is when the foot rolls inward, and overstretches the inside ankle ligaments.

What are the symptoms of an ankle sprain?

Ankle sprains are one of the most common injuries for children and adults alike. They are also the most under-treated. Repeat sprains and sprains that aren't treat properly can result in re-injury, long term pain, chronic ankle instability and unnecessary surgeries. For this reason, it is important to have the injury is evaluated by a specialist.


Typical symptoms of a sprained ankle include:

  • Ankle pain and swelling on the outside of the ankle and foot.

  • Some patients can't place their foot on the ground without pain.
  • The injured area becomes bruised and discolored.
  • There can be a feeling of imbalance as well; it may feel as though the ankle can roll again at any time.
  • You may also experience a locking or clicking of the ankle when it is moved.



How do we Diagnose the Severity of a Sprained Ankle?

After suffering for months from an ankle sprain that didn't heal, Cynthia is feeling relief from just a few sessions of physical therapy at UFAI.

It is likely that your doctor will take X-rays in the office to determine if there are any fractures or bone chips from the ligament tear, which are not uncommon. In some, usually chronic cases, special stress x-rays are taken to determine the amount of dislocation.


Occasionally, an MRI is needed to provide an enhanced image of the ligaments, tendons, and the cartilage of the joint to determine the true extent of your injury. 


There are three grades of severity for sprained ankles:


Grade 1 Sprain – Mild.

The ligaments are only slightly stretched, marked by swelling and soreness in the injured ankle.


Grade 2 Sprain – Moderate.

There is a small tear in the ligament that loosens the ankle joint. The ankle appears swollen, and patients feel pain and have a hard time putting weight on the injury.


Grade 3 Sprain – Severe.

A severe sprain is a complete tear of the ligament. There is quite a bit of pain and swelling. The ankle will feel very weak and patients won’t be able to put any weight at all on the foot.


Repeat sprains of the same ankle can cause a chronic ankle sprain. Chronic ankle sprains can cause pain for months, or even years, after the initial trauma, flaring up whenever the patient tries to play sports, dance, or exercise.



Treatment for Ankle Sprains

If you may have an ankle sprain, call your foot and ankle specialist. You may be asked to schedule an appointment for a closer examination, or your doctor may be able to give you a home treatment plan.


While the treatment options will depend on the severity of the injury, many ankle sprains can be successfully treated at home within 4-6 weeks with attentive care and rest.


RICE method

  • Ankle Sprain Treatment and RICE, University foot and ankle institute
    Rest. Avoid putting weight on the foot as much as possible, especially for the first week. Limit walking, and use crutches or a scooter to get around.
  • Ice. Use ice to bring down the swelling. Wrap a bag of ice or a cold ice pack in a paper towel and apply it to the ankle immediately after the injury. Ice the sprain for 15-20 minutes every 3-4 hours for the first couple days after the injury.
  • Compression. Your doctor may splint the ankle, or recommend an elastic wrap to limit the joint’s motion and compress the injury. Compression helps your ligaments to heal and prevent further injury.
  • Elevate. Prop the leg up at or above the level of your heart


Ankle brace

If there is minimal damage, a simple lace up ankle brace will be used with weight-bearing. An elastic bandage can also be used to immobilize the joint and provide ankle support.


Physical Therapy

Your physical therapist will provide you with strengthening exercises to restore normal range of motion. Stretches should be performed, beginning with gentle stretches, once the initial pain and inflammation has lessened. Prolonged periods of rest that accompany the recovery of an injured tendon result in shorten and tighten muscles.



For pain relief, you can use nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen.



Grade iii sprains usually require complete immobilization in a cast or a boot. This helps to make sure the ligaments have enough time to heal before they are used again.



In rare and very severe cases, your foot and ankle specialist might recommend surgery. An arthroscopy is performed through a small incision near the joint. The doctor inserts a narrow, flexible camera into the incision and makes the necessary repairs.


It is important to remember that proper protection of the ligament after a sprain and active physical therapy during a sprain will result in a better long-term outcome. Even with proper protection and bracing, 30% of ankle sprains can have secondary factors leading to pain. These include chronic ankle instability from loose ligaments, tendon tears, cartilage damage and scar tissue in the ankle joint. These problems can cause ankle instability, pain and swelling that often need to be corrected surgically.



Preventing Ankle Sprains 

Some ankle sprains simply can’t be prevented. Here are a few tips for keeping your ligaments safe and strong:

  • Take caution on slippery or uneven surfaces.
  • Stretch before and after athletic activities: prepare you body and muscles for activity. Changes in your activity level exposes you body to injury.Balance: improving balance will improve your ability to control your body in all types of positions
  • Strength training: the stronger the muscles are that support the ankle, less likely you are to suffer a sprain
  • Wear well-fitted shoes, appropriate for your activity
  • Avoid sudden turns and changes in direction during athletic activities
  • Be aware of the surface on which you walk, run or jump
  • Taping and bracing to support the ligaments



Why Partner with UFAI for Your Ankle Treatment?

University Foot and Ankle Institute is one of the largest and most technologically advanced providers of foot and ankle care in the country. The team of doctors at the Institute offers expert knowledge in the evaluation and treatment of all conditions of the foot and ankle for children and adults.


Our on-site physical therapy services, comprehensive imaging and bracing facilities allow for a team approach and one-stop care of your ankle injury.


Our physicians documented the largest ever study on a triad injury of the ankle. This triad consists of chronic scar tissue, ankle instability and tendon tear that can occur together due to ankle sprains. Our revolutionary surgical treatment of these cases has resulted in over a 97% return to full and unrestricted activity in our study group of more than 700 cases.


UFAI has worked with many orthopedic product companies to build or improve their products related to chronic ankle instability and pain. From bone and ligament anchors to tendon repair equipment and techniques, we are at the forefront of these revolutionary technology and techniques for foot and ankle care.

  • Foot and Ankle Surgeon and Director of University Foot and Ankle Institute
    Dr Bob Baravarian, University Foot and Ankle Institute

    Dr. Bob Baravarian is a Board Certified Podiatric Foot and Ankle Specialist. He is currently a member of UCLA Medical Group, Chief of Podiatric Surgery at Santa Monica/UCLA medical center and Orthopedic Hospital and an assistant clinical professor at the UCLA School of Medicine. He also serves as Director of University Foot and Ankle Institute.


    Dr. Baravarian has been involved in athletics his entire life and played competitive tennis in high school and college. He has an interest in sports medicine, arthritis therapy and trauma/reconstructive surgery of the foot and ankle. He is also fluent in five languages (English, French, Spanish, Farsi and Hebrew),

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