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Ankle sprain

Ankles sprains are common sports injuries, but can have other causes, including accidents with high-heeled shoes.

Ankle sprains involve an injury to ligaments in the ankle, the tough bands of tissue that hold the bones together.

Ligaments are flexible, but a sudden twist can cause them to stretch too far.

The risk of ankle sprain is greater if you:

  • Have sprained your ankle before.
  • Walk, run or play on uneven surfaces.
  • Wear shoes that don’t fit well or don’t have good support.
  • Play sports that require sudden changes in direction, such as football, rugby or tennis.

What does an ankle sprain feel like?

The symptoms of an ankle sprain are:

  • Ankle pain, which can range from mild to severe.
  • Swelling.
  • A popping sound during the injury.
  • Difficulty moving your ankle.
  • Bruising.
  • Instability of the ankle (with severe sprains).

Ankle sprains are divided into three grades. People with Grade I sprains may be able to walk without pain or a limp. Those with Grade III sprains are often in such pain that they can’t walk at all.

To diagnose a sprained ankle, your doctor will take a careful history of how the injury occurred and will examine your ankle. You may also need X-rays to rule out broken bones. MRI (magnetic resonance imaging) may show details of the ligament damage, but this doesn't need to be done in every case.

What’s the treatment for an ankle sprain?

Fortunately, minor to moderate ankle sprains should heal in their own, given time. To speed up the healing you can:

  • Rest the ankle. Avoid putting weight on your ankle as best you can. If the pain is severe, you may need crutches until it goes away.
  • Put ice on your ankle to reduce pain and swelling. Do this for 20 to 30 minutes, every three to four hours, for two to three days or until the pain has gone. After that, ice your ankle once a day until you have no other symptoms. Never put ice directly against the skin, wrap it in a cloth.
  • Compress your ankle. Use an elastic bandage to keep the swelling down. Start wrapping at your toes and work back up towards your leg.
  • Raise your ankle up on a pillow when you’re sitting or lying down.
  • Take anti-inflammatory painkillers. Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen will help with the pain and swelling. However, these medicines can have side effects, including an increased risk of bleeding and ulcers. They should be used only occasionally, unless your doctor specifically tells you otherwise.
  • Practise stretching and strengthening exercises if your doctor or physiotherapist recommends them.

In rare cases, an ankle sprain will require surgery. During the operation, the surgeon may remove pieces of torn ligament, bone and cartilage. The ligament may also be sewn back together. After surgery, you will have to wear a cast for one to two months.

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