Although often associated with women in high-heeled shoes, ankle sprains are a common ailment for all sorts of athletes. About 25,000 people get them every day.
And what is an ankle sprain, exactly? It’s an injury to one of the ligaments in your ankle. Ligaments are tough bands of tissue that hold your bones together. Although ligaments are flexible, all it takes is a sudden twist for them to stretch too far or snap entirely.
As with other subjective experiences, such as love, fear, or anger, there's no way to objectively measure pain. We asked Sean Mackey, MD, PhD, chief of the Pain Management Division and associate professor of anesthesia at Stanford University School of Medicine, to explain the unpleasant sensation we all feel in different ways.
Ankle sprains are graded according to severity, with Grade I indicating that ligaments are stretched but not torn; Grade II indicating that ligaments are partially torn; and Grade III, a fully torn ligament.
You might get a sprain if your foot lands on the ground at an angle, or with too much force. Your risk of an ankle sprain is higher if you:
Have had previous ankle sprains
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, like football, soccer, and basketball
Ankle sprains are divided into three grades. People with Grade I sprains may be able to walk without pain or a limp. But those with Grade III sprains are often in such pain that they can’t walk at all.
To diagnose an ankle sprain, your doctor will give you a thorough physical exam. You may also need X-rays to rule out broken bones. MRI (magnetic resonance imaging) may show details of the ligament damage, but doesn't need to be done in every case.
What’s the Treatment for an Ankle Sprain?
Happily, minor to moderate ankle sprains should heal on their own, given time. To speed the healing, you can do the following:
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.
Ice your ankle to reduce pain and swelling. Do it for 15-20 minutes every two to three hours for two days, or until the swelling is improved. After that, ice it once a day until you have no other symptoms.
Compress your ankle. Use an elastic bandage to keep down swelling. Start wrapping at your toes and work back towards your leg.
Elevate your ankle on a pillow when you’re sitting or lying down.
Use braces or ankle stirrups to give your ankle support.
Take anti-inflammatory painkillers. Nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen, naproxen, or aspirin will help with pain and swelling. However, these drugs have side effects, like stomach upset and an increased risk of bleeding and ulcers. They are best taken with food, and they should be used only occasionally, unless your doctor specifically says otherwise.
Practice stretching and strengthening exercises if your doctor recommends them.
Even Grade III sprains, in which the ligament is completely torn, may heal naturally. In rare cases, you might need surgery. During the operation, the surgeon might remove bits of torn ligament, bone, and cartilage. The ligament may also be repaired (sutured together), or reconstructed (replaced with a biologic material). After surgery, you may need a cast for one to two months.