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Ankle pain is commonly due to a sprain or tendinitis. The severity of ankle sprains ranges from mild (which can resolve within 24 hours) to severe (which can require surgical repair).

Ankle Sprain

Ankle Sprain

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. Ankle sprains are common sports injuries but can also happen during everyday activities such as walking or even getting out of bed.

  • The ankle joint is made up of three bones.

    • The tibia is the major bone of the lower leg, and 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 two bones in the lower leg. Its lower end forms the lateral malleolus, the outer bump of the ankle.

    • The talus is the top bone of the foot. 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 greater than normal stress.

    • Tendons also can be pulled off the bone. This type of injury is called an avulsion.

  • Ligaments provide connection between bones. Sprains are injuries to the ligaments.

    • The ankle has many bones that come together to form the joint, so it 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 on the front-outer part of the ankle joint.

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

What are the causes of Ankle Sprain?

Ligaments are injured when a greater 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.)

  • Inversion injuries, in which the foot rolls inward, are more common than eversion injuries (also referred to as a high ankle sprain), in which the foot twists outward.

What are the symptoms of ankle sprain?

Tissue injury and inflammation occur when an ankle is sprained. 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. The following are signs of inflammation:

  • Swelling, due to increased fluid in the tissue, is sometimes severe.

  • Pain: The nerves are more sensitive. The joint hurts and may throb. The pain can worsen when the sore area is pressed or the foot moves in certain directions (depending upon which ligament is involved) and during walking or standing.

  • Redness and warmth: Caused by increased blood flow to the area

When do you need to seek for Medical Care?

Usually, an ankle sprain itself does not require a trip to the doctor. The problem is how to tell a sprain from a more serious injury such as a fracture (break). If any of the following occur, contact your doctor.

  • Pain is uncontrolled, despite the used of over-the-counter medications, elevation, and ice.

  • One is unable to walk or cannot walk more than a few steps without severe pain.

  • The ankle fails to improve within five to seven days. The pain need not be gone, but it should be improving.

The indications to go to a hospital’s emergency department are similar to those for which to call the doctor. The following conditions suggest a fracture or more serious injury or that a splint may be needed for pain control:

  • You feel severe or uncontrolled pain.

  • You cannot move the injured ankle.

  • The foot or ankle is misshapen beyond normal swelling.

  • You cannot walk four steps, even with a limp.

  • You experience severe pain when pressing over the medial or lateral malleolus, the bony bumps on each side of the ankle.

  • You experience loss of feeling in the foot or toes.

  • You have pain and swelling in the back of the ankle (heel pain), over the Achilles tendon area, or the inability to push the toes down (forward-like pressing a gas pedal).

  • You have pain or swelling into the upper part of the lower leg just below the knee or swelling of the calf muscle.

  • Redness or red streaks spreading out from the injury are observed.

  • You don’t know how serious the injury may be or are unsure how to care for it.

How to diagnose ankle sprain?

The doctor will perform a physical exam to see if a fracture or other serious injury has happened that requires immediate care.

  • The examination should check that the nerves or arteries to the foot have not been injured and that the knee or the rest of the leg is not involved.

    • The doctor will handle and move the foot and ankle to determine what bony areas are involved.

    • The Achilles tendon will be checked for signs of rupture.

  • X-rays are often needed to confirm that a fracture is present. In some cases of fracture, a CT scan may be needed.

What are the Medical treatments for ankle sprain?

  • Brace or cast to reduce motion / immobilise the ankle. Crutches are frequently provided so the patient does not have to bear weight on the injured ankle. This will allow the Ligament to heal and to avoid recurrent ankle sprain in the future.

  • The most common medications used for ankle sprains are anti-inflammatory pain medications that both reduce pain and help control inflammation.

Read more about Arthroscopic Ankle Surgery

Read more about Ankle Instability

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