Ankle Sprains
Background
The primary stabilizer of the ankle joint is a ligament called the anterior talofibular ligament (ATFL). The ATFL attaches one of your leg bones (the fibula) to a key foot bone (the talus) and provides stability to your ankle when you walk, run, cut, and jump.
In the vast majority of ankle sprains, the ATFL is torn or completely ruptured. This results in pain, swelling, and bruising that can make it difficult to stand, walk, exercise, or work. Without treatment, it can progress to chronic instability, disability, and pain.
Ankle sprains can happen from minor or major trauma. An example of minor trauma includes stepping off a curb and twisting your ankle inward. Examples of major trauma include high-energy sports injuries, car accidents, and falls from height.
Diagnosis
Ankle sprains are diagnosed in the clinic with physical exam and x-rays. You do not need an MRI if your injury was within the last 6 weeks.
In his physical exam, Dr. Bohl will evaluate the ATFL to determine whether it is intact. On the x-ray, he will evaluate the foot and ankle for bony fractures. If the ATFL is injured and you lack any significant fractures, then by definition, you have an ankle sprain.
Treatment of new ankle sprains
New ankle sprains are always treated without surgery. The protocol is relatively similar for all patients:
2 weeks in an orthopaedic boot, ice, rest, and anti-inflammatories
4 weeks in an ankle brace and physical therapy
The purpose of this protocol is to protect your ankle until healing of the ATFL is initiated, and then to retrain the muscular stabilizers around your ankle to prevent recurrent injury. The duration and frequency of physical therapy can be tailored to your schedule and preference.
Recurrent ankle sprains or persistent pain
Most patients do well with nonsurgical treatment of a new ankle sprain. However, a small proportion of patients with severe sprains develop chronic symptoms. These patients might have difficulty walking or returning to sports due to recurrent sprains. Or they may simply have chronic pain in their ankle.
The next step is to obtain an MRI. The MRI will help to explain the chronic symptoms. The MRI will help to diagnose:
You can click on the links above to learn more about treatment options for each condition.