Five questions to ask about ankle sprains

Ankle sprains are common. There are approximately two million ankle injuries in the United States every year. Unfortunately, more than 70% of ankle sprains happen to people with previous ankle sprains, many of which had not properly healed.

Ankle sprains are an injury to the ligaments that surround the ankle joint. Ligaments are strong tissues that connect bones to other bones. The severity of a sprain depends on if the ligament was stretched or completely torn.

Sprains can also be associated with fractures (breaks). But sprains and fractures are different types of injuries and vary in their severity.

When should I see a doctor?

The first reason to see a doctor is to find out if the ankle is broken. Signs of a break include not being able to bear weight when taking at least four steps. Other signs include tenderness of the bony bumps of the ankle or foot. In these situations, X-rays should be done.

Another reason to see a doctor is to lower the chances of future injury or having long-term ankle problems. In short, seek medical guidance. Also, rehabilitation (rehab) exercise program can help keep ankle problems from happening again.

How long does recovery usually take?

Recovery time for most ankle sprains is two to six weeks. It depends on the injury and the recommended treatment plan. Treatment involves:

• Controlling inflammation (pain, redness and swelling)
• Regaining full range of motion and strength
• Regaining the physical control and endurance needed for activities

How can I control swelling?

Keeping inflammation down at the beginning will reduce pain and swelling. This involves:

• Ice (usually 10–20 minutes at a time, with at least 30 minutes between sessions)
  
• Compression (using an elastic bandage to reduce swelling)
• Elevation (raising your ankle above the level of your heart)
• Rest

You may need to use crutches or wear a walking boot for a while. But because early movement improves outcomes, it’s good to start protected weight-bearing activities as soon as possible.

Completing all phases of rehab allows for a safe return to activities. This also lowers the chances of long-term problems. Rehab should help improve strength and balance, as well as guide patients in when to go back to sports and exercise.

Do braces help keep sprains from happening?

Braces, specifically an air-stirrup brace or lace-up support, can help with early movement. They also protect against re-injury after return to sports or activities. But to have this benefit, braces must be worn during all high-risk activities for at least a year.

Also, braces don’t promote healing or retrain muscles, ligaments and reflexes to react to the stresses placed on them. To heal fully, you must complete all phases of rehabilitation.

How will I know when I’m ready to play again?

In general, once you have full movement and strength and can do all sports specific activities without pain, you can return to play.

One way to test this is called the “rule of 20s.” It means being able to do the following on the affected ankle without problems:

• Run 20 yards
• Cut 20 times
• Hop on the leg 20 times
• Balance with your eyes closed for 20 seconds

Remember that the chances of reinjury last up to 12 months, even after full rehab. Wearing some type of ankle support and getting proper training can help. Both are an important part of safely returning to play.

Our sports and performance medicine care team specializes in the treatment of foot and ankle sprains. For more information or to make an appointment, call 1-206-860-5584.

By Jeremy D. Johnson, MD, MPH, RMSK

The information provided is for general informational purposes only and is not intended to be medical advice or a substitute for professional health care. You should consult an appropriate health care professional for your specific needs.