Ankle Sprain

An ankle sprain occurs when the ligaments, which are tough bands of tissue that stabilize the ankle joint, are stretched or torn. This injury typically affects the lateral ligaments on the outside of the ankle, though the ligaments on the inside of the ankle may also be strained. A sprained ankle is often colloquially referred to as a twisted ankle.

Ankle sprains can range in severity:

• Mild (Grade 1): The ligament is stretched but not torn. Symptoms are typically minimal, and function is preserved.
• Moderate (Grade 2): The ligament is partially torn, causing pain, swelling, and some loss of function.
• Severe (Grade 3): The ligament is completely torn, leading to significant swelling, instability, and difficulty bearing weight.

Ankle sprains can occur in people of all ages and activity levels, from athletes to those performing daily activities.

The symptoms of an ankle sprain vary depending on the severity of the injury. Symptoms often develop immediately after the injury but may worsen over the next 24 hours.

Common signs include:

1. Pain: Sharp or throbbing pain is felt at the site of the sprain, particularly during movement or weight-bearing.
2. Swelling: The injured area may swell rapidly.
3. Bruising: Discoloration may appear around the ankle as a result of small blood vessel damage.
4. Stiffness: Reduced range of motion in the ankle joint is common.
5. Instability: The ankle may feel unstable or give way, especially in severe sprains.
6. Difficulty Walking: Bearing weight on the affected foot can be challenging or impossible in more severe cases.

Ankle sprains occur when the foot twists or turns beyond its normal range of motion, causing the ligaments to overstretch or tear. The most common cause is when the foot rolls inward, stretching the ligaments on the outside of the ankle. Common causes include:

1. Sports Injuries: Activities involving running, jumping, or sudden directional changes (e.g., basketball, soccer, or tennis) are frequent culprits.
2. Falls: Losing balance and rolling the foot inward or outward can lead to a sprain.
3. Uneven Surfaces: Walking or running on uneven terrain increases the risk of twisting the ankle.
4. Improper Footwear: Wearing high heels, shoes without proper support, or shoes not designed for the activity can contribute to injury.
5. Weakness or Fatigue: Weak muscles or tired ligaments are less able to stabilize the ankle, making them prone to injury.
6. Previous Injuries: A history of ankle sprains increases the risk of reinjury due to lingering ligament weakness or instability.

When an ankle sprain occurs, an accurate diagnosis is essential to determine the severity of the injury and plan the appropriate treatment. Dr. Allison Boden uses a combination of patient history, physical examination, and imaging tests to confirm the diagnosis.

Medical History

Dr. Boden begins by asking how the injury occurred, the symptoms experienced, and whether the patient has a history of ankle injuries.

Physical Examination

During the physical exam, Dr. Boden evaluates the ankle for swelling, bruising, tenderness, and range of motion. She may gently manipulate the joint to assess ligament stability.

Imaging Studies

• X-rays: While ligaments are not visible on X-rays, these images help rule out fractures, which can present with similar symptoms.
• MRI (Magnetic Resonance Imaging): In cases of severe sprains or chronic instability, an MRI may be ordered to visualize the soft tissues and assess the extent of ligament damage. This is often performed after a course of physical therapy if the patient is unable to return to activity and not done in the acute setting.
• Ultrasound: This imaging technique may be used to evaluate real-time ligament movement and detect tears.

Dr. Boden’s expertise ensures that even subtle injuries are accurately diagnosed, which is crucial for a successful recovery.

While many mild ankle sprains can heal with at-home care, it is important to seek medical attention when:

• The pain and swelling are severe.
• The patient cannot bear weight on the injured foot.
• The ankle appears deformed or misaligned.
• Symptoms do not improve after several days of rest and self-care.

Dr. Boden’s specialized care is particularly valuable for athletes, active individuals, or those with a history of recurrent ankle injuries, as proper treatment can prevent long-term complications such as chronic instability or arthritis.