More than 20,000 ankle sprains occur in the United States every day. A sprained ankle is a very common condition, but an ankle sprain is never just an ankle sprain, even if it’s minor. In fact, pain and difficulty walking are just the beginning; not treating or improperly treating a sprained ankle can lead to chronic pain and disability for years to come.
What Is a Sprain?
It’s helpful to learn just what a sprain is in order to understand why it’s dangerous and how it’s treated. Sprain is a general term for a damaged ligament—a tough, fibrous piece of tissue that attaches muscle to bone. Sprains can range from a mild stretching of the ligament to a complete tear.
In the ankle, the most often sprained ligaments are the lateral ligaments on the outside of the ankle. These ligaments get damaged when the ankle rolls so that the outside of the foot touches the ground. This can happen for many reasons, including sports, the shoes people wear, even just stepping wrong, which is why sprained ankles are so common.
Long-Term Consequences of a Sprain
Because most ankle sprains can be treated without surgery, they may have the perception of not being a serious injury. However, ankle sprains—even a mild sprain—can potentially lead to long-term consequences.
Chronic ankle instability is a condition in which the ligaments of the ankle become loose, putting you at risk for more sprains. About 20 percent of acute ankle injuries become chronic ankle instability, and the most common reason for the condition is a failure to rehabilitate the original injury.
Another common consequence of an improperly treated sprained ankle is a loss of range of motion of the ankle. To demonstrate, sit on the floor with your legs straight out in front and try to bring your toes toward your face. That motion is called dorsiflexion, and a sprained ankle can limit that.
A loss of ankle mobility may lead to a change in movement and how you walk. You may find yourself favoring the uninjured leg. Over time, this can lead to muscle imbalances and hip or lower back pain.
Finally, people who have sustained an ankle injury have far higher rates of post-traumatic arthritis in the ankle than people who haven’t—more than nine percent versus less than two percent according to a small 2015 study published in the Journal of Athletic Training. Post-traumatic arthritis is a form of osteoarthritis that develops after an injury. With this form of arthritis, the cartilage that wraps the ends of bones in a joint wears out, resulting in painful bone-on-bone contact and the development of bone spurs.
Treating a Sprained Ankle
The first thing to do when you suspect you’ve had an ankle sprain is the RICE protocol to reduce the damage, swelling and pain from a sprain.
- Rest the ankle for as much as possible over the next couple of days following injury
- Ice the ankle for no more than 20 minutes at a time to reduce swelling (exceeding that could result in nerve damage)
- Compress the ankle snugly by wrapping it in an elastic bandage (wrapping it too tightly can result in reduced blood flow and slower healing)
- Elevate the ankle until it’s level with the heart to help reduce pain and swelling
For minor sprains, it’s often a good idea to wear an ankle support or air cast along with using the RICE protocol. More treatment might be necessary depending on the severity of the sprain. That can include immobilization to hold the ankle in place while the ligaments heal, and physical therapy to return range of motion to the joint and strength to the surrounding muscles.
Not treating an ankle sprain can be a big deal, but treating one doesn’t have to be. In my practice, I have treated hundreds of sprained ankles and cases of chronic ankle instability. If you’ve sustained a sprained ankle, don’t wait—request an appointment with me or any of our foot and ankle specialists today.