Just a sprained ankle?

In a single year, almost 1 million Americans will sprain an ankle. Most ankle injuries occur in young people (aged 25 or younger) and more females sprain their ankles than males (57%). It’s such a common injury that by the time you are 25, it’s almost rare to find someone who has never sprained an ankle. But just because it’s a common injury doesn’t make it an easy injury to recover from.  

There are two kinds of ankle sprains — a lateral ankle sprain ( 90%) and a high ankle sprain. Lateral ankle sprains account for most ankle injuries — the kind where you roll your foot in or under. A high ankle sprain can be more serious initially with a higher incidence of fracture, but occurs much less frequently.  

For any sprain, there are three degrees of severity. A grade 1 sprain involves minor tearing of some of the fibers of the ligament, but isn’t severe enough to cause any laxity, or looseness, in the ligament. There will be some swelling, but not very severe. A grade 2 sprain involves tearing of more ligament fibers, and there will be some laxity present. Expect to see much more swelling with grade 2 sprain and likely a lot of bruising. A grade 3 sprain involves a complete rupture of the ligament.  

With any grade of ankle sprain, the initial treatment is to POLICE it — Protect, Optimal loading, Ice, Compression, and Elevation. For a grade 1 sprain, you might not need a brace, but for more severe sprains you may need a brace, boot, or crutches. Because the ankle is the first joint that takes any impact when you take a step, it is critical to address it early. If not addressed properly, you may experience pain at the knee, hip, or back further down the road, especially if you’re returning to high level sports.  

Early physical therapy will focus on reducing swelling, pain, and getting you to walk normally. We can start balance and strengthening early on as well, and this improves long term function and reduces injury risk. Once you can walk and swelling is more stable, the focus shifts to sport specific activities — running, jumping, and directional changes. Starting back on these too early may cause compensations that hurt the knee or hip so it is helpful to have some guidance with your form.  

Many people have sprained an ankle more than once, which can sometimes lead to what is called a chronic ankle instability. At this point, the ligament may be torn fully or partially, but you can still perform similar exercises — strength, balance, and control exercises — to improve stability without undergoing surgery. For active individuals, it is especially important to work on balance and control at the ankle so that no further injuries occur at the knee or hip.  

Another common question we hear is: should I wear a brace to prevent an ankle sprain? While no brace can truly prevent a sprain, if you’ve had a recent sprain it is recommended to wear one for the duration of the current sport season while also working on rehab exercises. Research shows that ankle braces and ankle taping have the same efficacy. Bracing or taping for the duration of a season will not decrease strength or control at the ankle. Generally, we recommend wearing a brace only for activity, that way your muscles have a chance to work on their own. If you’ve never sprained an ankle, you don’t need to wear a brace for prevention.  

Let us know if you have more questions on ankle sprains or if we can help you recover from one!