Defination:
A sprained ankle is an injury that occurs when you roll, twist or turn your ankle in an awkward way. This can stretch or tear the tough bands of tissue (ligaments) that help hold your ankle bones together.
Ligaments help stabilize joints, preventing excessive movement. A sprained ankle occurs when the ligaments are forced beyond their normal range of motion. Most sprained ankles involve injuries to the ligaments on the outer side of the ankle.
Most people have twisted an ankle at some point in their life. But if your ankle gets swollen and painful after you twist it, you have most likely sprained it. This means you have stretched and possibly torn the ligaments in your ankle.
Ankle sprains are classified as grade 1, 2, and 3. Depending on the amount of damage or the number of ligaments that are damaged, each sprain is classified from mild to severe. A grade 1 sprain is defined as mild damage to a ligament or ligaments without instability of the affected joint. A grade 2 sprain is considered a partial tear to the ligament, in which it is stretched to the point that it becomes loose. (click to see)A grade 3 (click to see)sprain is a complete tear of a ligament, causing instability in the affected joint. Bruising may occur around the ankle.
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Inversion(lateral) ankle sprain: click to see
The most common type of ankle sprain occurs when the foot is inverted too much, affecting the lateral side of the foot. When this type of ankle sprain happens, the outer, or lateral, ligaments are stretched too much. The anterior talofibular ligament is one of the most commonly involved ligaments in this type of sprain. Approximately 70-85% of ankle sprains are inversion injuries.
When the ankle becomes inverted, the anterior talofibular and calcaneofibular ligaments are damaged. This is the most common ankle sprain.
Eversion (medial) ankle sprain:
A less common type of ankle sprain is called an eversion injury, affecting the medial side of the foot. When this occurs, the medial, or deltoid, ligament is stretched too much.
High ankle sprain:
A high ankle sprain is an injury to the large ligaments above the ankle that join together the two long bones of the lower leg, called the tibia and fibula. High ankle sprains commonly occur from a sudden and forceful outward twisting of the foot, which commonly occurs in contact and cutting sports such as football, rugby, ice hockey, roller derby, basketball, volleyball, lacrosse, softball, baseball, track, ultimate frisbee, gridiron, tennis and badminton and horse riding.
Symptoms:
The most common symptoms are :-
!.Pain, especially when you bear weight on the affected foot
2.Swelling and, sometimes, bruising
3.Restricted range of motion
Some people hear or feel a “pop” at the time of injury.
Causes:
Movements – especially twisting, turning, and rolling of the foot – are the primary cause of an ankle sprain.
The risk of a sprain is greatest during activities that involve explosive side-to-side motion, such as badminton, tennis or basketball. Sprained ankles can also occur during normal daily activities such as stepping off a curb or slipping on ice. Returning to activity before the ligaments have fully healed may cause them to heal in a stretched position, resulting in less stability at the ankle joint. This can lead to a condition known as Chronic Ankle Instability (CAI), and an increased risk of ankle sprains.
The following factors can contribute to an increased risk of ankle sprains:
Weak muscles/tendons that cross the ankle joint, especially the muscles of the lower leg that cross the outside, or lateral aspect of the ankle joint (i.e. peroneal or fibular muscles);
1.Weak or lax ligaments that join together the bones of the ankle joint – this can be hereditary or due to overstretching of ligaments as a result of repetitive ankle sprains;
2.Poor ankle flexibility;
3.Lack of warm-up and/or stretching before activity;
4.Inadequate joint proprioception (i.e. sense of joint position);
5.Slow neuron muscular response to an off-balance position;
6.Running on uneven surfaces;
6.Shoes with inadequate heel support; and
7.Wearing high-heeled shoes – due to the weak position of the ankle joint with an elevated heel, and a small base of support.
Ankle sprains occur usually through excessive stress on the ligaments of the ankle. This is can be caused by excessive external rotation, inversion or eversion of the foot caused by an external force. When the foot is moved past its range of motion, the excess stress puts a strain on the ligaments. If the strain is great enough to the ligaments past the yield point, then the ligament becomes damaged, or sprained
Diagnosis:
Your doctor will ask you how the injury occurred and if you have hurt your ankle before. He or she will check your foot and ankle, your lower leg, and even your knee to see if you are hurt anywhere else.
If the sprain is mild, your doctor may not order X-rays. But with more severe sprains, you may need X-rays to rule out a broken bone in the ankle or the foot. It is possible to break a bone in your foot or ankle at the same time as a sprain.
In most cases, doctors order X-rays in children with symptoms of an ankle sprain. This is because it is important to find and treat any damage to the growth plates in bones that support the ankle.
Treatment:
In many cases you can first use the PRINCE approach to treat your ankle:
1.Protection. Use a protective brace, such a brace with a built-in air cushion or another form of ankle support.
2.Rest. You may need to use crutches until you can walk without pain.
3.Ice. For at least the first 24 to 72 hours or until the swelling goes down, apply an ice pack for 10 to 20 minutes every hour or two during the day. Always keep a thin cloth between the ice and your skin, and press the ice pack firmly against all the curves of the affected area.
4.NSAIDs or acetaminophen. NSAIDs (such as Advil and Motrin) are medicines that reduce swelling and pain. Acetaminophen (such as Tylenol) reduces pain.
5.Compression. An elastic compression wrap, such as an ACE bandage, will help reduce swelling. You wear it for the first 24 to 36 hours. Compression wraps do not offer protection. So you also need a brace to protect your ankle if you try to put weight on it.
6.Elevation. Raise your ankle above the level of your heart for 2 to 3 hours a day if possible. This helps to reduce swelling and bruising.
Proper treatment and rehabilitation (rehab) exercises are very important for ankle sprains. If an ankle sprain does not heal right, the joint may become unstable and may develop chronic pain. This can make your ankle weak and more likely to be reinjured. Before you return to sports and other activities that put stress on your ankle, it’s a good idea to wait until you can hop on your ankle with no pain. Taping your ankle or wearing a brace during exercise can help protect your ankle. Wearing hiking boots or other high-top, lace-up shoes for support may also help. But use caution. Don’t force your foot into a boot if you feel a lot of pain or discomfort.
If your ankle is still unstable after rehab, or if the ligament damage is severe, your doctor may recommend surgery to repair the torn ligaments.
Rehabilitation:
Rehab exercises can begin soon after the injury. You can try to walk or put weight on your foot while using crutches if it doesn’t hurt too much. Depending on your pain, you can also begin range-of-motion exercises pop out while you have ice on your ankle. These exercises are easy to do-you just trace the alphabet with your toe. This helps the ankle move in all directions.
Ask your doctor about other rehab. Stretching, strength training, and balance exercises may help the ankle heal totally and may prevent further injury.
Prevention:
Take the following steps to help prevent a sprained ankle:
1.Warm up before you exercise or play sports.
2.Be careful when walking, running or working on an uneven surface.
3.Wear shoes that fit well and are made for your activity.
4.Don’t wear high-heeled shoes.
5.Don’t play sports or participate in activities for which you are not conditioned.
6.Maintain good muscle strength and flexibility.
7.Practice stability training, including balance exercises.
Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.
Resources:
http://en.wikipedia.org/wiki/Sprained_ankle
http://www.mayoclinic.com/health/sprained-ankle/DS01014/DSECTION=symptoms
http://www.webmd.com/a-to-z-guides/ankle-sprain-overview
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