An ankle sprain refers tearing of the strong ligaments that support the ankle. This is a very common injury that happens when the ankle ligaments stretch beyond their limits and tear.

Ankle sprains can be mild, moderate, or severe, depending on how much damage there is to the ligaments.

Grading of Ankle Sprains

Grading of  ankle sprains depend upon the damage to the ligament, whether simply stretched,  slightly torn, or completely torn.

Grade I – Mild ankle sprain. This is stretching or slight tearing of the ligament with mild tenderness, swelling, and stiffness. The ankle feels stable. One can walk with minimal pain.

Right foot. A light 2nd degree sprain, two days after injury. By Boldie (Own work) [Public domain], via Wikimedia Commons

Grade III – Severe ankle sprain. This involves a complete tear of the affected ligament/s. It is accompanied by severe swelling and bruising. The ankle is unstable, walking is almost impossible because there is intense pain.

Treatments for Ankle Sprain

The treatment for a sprained ankle depends on the severity of injury.

Nonsurgical treatments include over-the-counter pain medications such as ibuprofen acetaminophen, or naproxen. The RICE method – REST, ICE, COMPRESS, and ELEVATE – can be done in the first 48 hours. An ankle brace or a cast boot can be prescribed, depending on the grade of the sprain. Ankle taping can also be done by a skilled individual. Crutches may be recommended for at least a couple of days after the injury. To improve ankle strength, physical therapy may then follow.

Surgical treatments for ankle sprains are for injuries that fail to respond to nonsurgical treatments and for patients with persistent ankle instability despite months of therapy and conservative treatments.

Surgical options include arthroscopy to look inside the ankle joint and remove any loose fragments of cartilage or bone. Reconstruction or repair —  ligament repair, tendon repair or osteochondral lesion treatment may be performed. The patient should discuss the various options with their surgeon to determine which procedure is best for their situation. The ultimate goal is to have a patient function at their pre-injury level and perform activities of a daily living without continued ankle sprains.

Ankle ligament repair and peroneus tears

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