Ankle Sprain: Twist in the ankle

What is ankle sprain? Ankle pain involves discomfort in one or both ankles, and is most commonly a result of ankle sprain. An ankle sprain is an injury to the ligaments, tissue that connects bones to one another. Most cases of ankle sprain involve twisting of ankle inwards resulting in small tears of the ligament). The tears may cause the affected area to swell and bruise and makes it difficult for the joint to bear weight of the body. What are the causes of the disorder? An ankle sprain results from an injury to the ligaments in the ankle. Ligaments are strong bands of tissue that hold two bones together, and while these tissues are flexible, a sudden twisting action of the body can make them snap or stretch too far. The ankle is the most common location for tearing or stretching of ligaments. A person may sprain his/her ankle if the foot lands on the ground with too much force or at an angle. The risk of developing an ankle strain is high in the following cases:

1. People who have had a sprain previously
2. Walking, running or playing on uneven surfaces
3. Wearing ill-fitted shoes or shoes without support
4. Playing sports that involve sudden changes in direction, like soccer and basketball.

What one needs to know about symptoms or signs? Symptoms of an ankle sprain are:

1. Pain in the ankle, which ranges from mild to severe
2. Swelling and bruising of ankle
3. Popping sound at time of injury
4. Difficulty in moving the ankle
5. Ankle instability (in severe cases)

Ankle sprains can be divided into three grades - those with Grade I sprain can walk without pain or limp, but those with Grade III sprain experience severe pain that makes it difficult to walk at all. Which specialist should be consulted in case of signs and symptoms? People who suffer a sprain must consult a doctor who specializes in orthopaedic surgery or sports medicine. What are the screening tests and investigations done to confirm or rule out the disorder? The doctor will conduct a thorough physical exam to identify an ankle sprain. Diagnosis is confirmed through x-rays to rule out broken bones. Magnetic resonance imaging (MRI) may be conducted to view ligament damage in greater detail, but it is not required in every case. What treatment modalities are available for management of the disorder? Treatment of ankle sprains involves:

1. Medication - Non-steroidal anti-inflammatory drugs (NSAIDs), like ibuprofen or aspirin or other over-the-counter pain medications help with pain and swelling. However, some of these drugs are associated with an increased risk of bleeding and ulcers, and thus must be taken occasionally or as suggested by the doctor.
2. Therapy - Applying ice to the ankle minimizes swelling in mild to moderate sprains. The doctor may also immobilise the ankle by placing it in a brace or splint. Over time, physical therapy in form of stretching and strengthening exercises may be recommended.
3. Surgery - Grade III sprains in which a ligament is completely torn may require surgery in some cases. During the surgery, the surgeon removes bits of ligament, cartilage and bone. The ligament may be reconstructed (replaced with a biological material) or repaired (sutured together). Post operation, the ankle is placed in a cast for one to two months.

What precautions or steps are necessary to stay healthy and happy during the treatment? Some home-care remedies can alleviate the pain and swelling associated with ankle sprain:

1. Rest - As far as possible, applying weight on the ankle must be avoided. Braces or ankle stirrups can provide support. It helps to elevate the ankle on a pillow while lying down or sitting.
2. Ice pack - Applying ice on the ankle for 20-30 minutes every three to four hours can help reduce pain and swelling.
3. Compression - An elastic bandage can be wrapped from the toes to upper leg to keep down the swelling.

How can the disorder be prevented from happening or recurring?

1. Regular stretching and strengthening exercises as part of any sporting or physical activity can help minimize risk to ankle sprain.
2. It is important to maintain the required level of fitness for a particular sport. Further, regular conditioning can prevent injuries in people who have physically challenging jobs.
3. Wearing shoes with good support and fit is important.
4. One must avoid walking, running or jumping on uneven surfaces.

Sources:"Ankle pain," MedlinePlus, NLM, NIH, https://www.nlm.nih.gov/medlineplus/ency/article/003167.htm"Ankle Sprain," WebMD.com, https://www.webmd.com/pain-management/ankle-sprains?page=2"Sprains and Strains: What's the Difference?" American Academy of Orthopaedic Surgeons, AAOS, https://orthoinfo.aaos.org/topic.cfm?topic=A00111