Ankle Sprain

Ankle Sprain Overview

The ankle joint, which connects the foot with the lower leg, is injured often. An unnatural twisting motion can happen when the foot is planted awkwardly, when the ground is uneven, or when an unusual amount of force is applied to the joint. Such injuries happen during athletic events, while running or walking, or even doing something as simple as getting out of bed.

Ankle injuries can be painful and can make it hard to carry out your daily activities.

A review of the important parts of the ankle, and injuries that can happen to them, is appropriate:

• The ankle joint is made up of 3 bones.
  
  
  • The tibia is the major bone of the lower leg. It bears most of the body's weight. Its bottom portion forms the medial malleolus, the inside bump of the ankle.
    
    
  • The fibula is the smaller of the 2 bones in the lower leg. Its lower end forms the outer bump of the ankle.
    
    
  • The talus is the top bone of the foot.
    
    
  • Fractures are breaks in these bones.
  
  
• Tendons connect muscles to bones.
  
  
  • Several muscles control motion at the ankle. Each has a tendon connecting it to one or more of the bones of the foot.
    
    
  • Tendons can be stretched or torn when the joint is subjected to more than normal stress.
    
    
  • Tendons also can be pulled off the bone to which they attach. An example of an injury of this type would be an Achilles tendon rupture.
  
  
• Ligaments provide connection between bones. Injuries to the ligaments are called sprains.
  
  
  • The ankle has many ligaments holding it together. Stress on these ligaments can cause them to stretch or tear.
    
    
  • The most commonly injured ligament is the anterior talofibular ligament that connects the front part of the fibula to the talus bone.

Ankle Sprain Causes

Ligaments are injured when more than normal stretching force is applied to them. This happens most commonly when the foot is turned inward or inverted. This kind of injury can happen in the following ways:

• Awkwardly planting the foot when running, stepping up or down, or during simple tasks such as getting out of bed

• Stepping on a surface that is irregular, such as stepping in a hole

• Athletic events when one player steps on another player (A common example is a basketball player who goes up for a rebound and comes down on top of another player’s foot. This can cause the rebounder’s foot to roll inward.)

Ankle Sprain Symptoms

When an ankle is injured with a sprain, tendon injury, or fracture, inflammation occurs. Blood vessels become "leaky" and allow fluid to ooze into the soft tissue surrounding the joint. White blood cells responsible for inflammation migrate to the area, and blood flow increases as well. Typical changes that happen with inflammation, include the following:

• Swelling because of increased fluid in the tissue: Sometimes the swelling is so severe that you can leave an indentation in the swollen area by pressing on it with your finger.
• Pain because the nerves are more sensitive: The joint hurts and may throb. You can make the pain worse by pressing on the sore area, by moving the foot in certain directions (depending upon which ligament is involved), and by walking or standing.
• Redness and warmth caused by increased blood flow to the area