It’s Not “Just” an Ankle Sprain

As foot and ankle surgeons at Rothman Orthopaedics, we see it happen all the time—one minute a person is walking, the next, they misstep and “twist” their ankle, landing them on the ground and eventually into our office. Sprained ankles are painful and can temporarily limit a patient’s ability to walk normally, but properly diagnosing and treating an ankle injury in a timely manner is imperative to proper healing, and reduces the chances of long-term, chronic ankle pain.

I often hear the misconception from people that, “it’s just a sprain, no big deal,” but sometimes a sprain can be or become more of an issue. Upon examination and after diagnostic tests, such as x-rays and at times an MRI, ankle sprains are graded based on severity and location of the injury to the ankle structures. 

  • Grade one is least severe – Stretching and slight tearing of the ligament; 
  • Grade two is more severe, with an  incomplete ligament tear; and
  • Grade three is a complete tear of the ligament that comes with increasing symptoms and severity in pain and swelling.

Another reason to seek medical care with a foot and ankle specialist is to be evaluated for a fracture aka “broken ankle.” Determining the severity of the ligament damage or if there is a bone injury play a major role in how we aim to treat the injury and how long the recovery will last. 

A bone fracture typically takes six to eight weeks to heal, while a ligament sprain can take between three and six months to heal. The time difference in healing a bone versus a ligament is all about blood flow. The bone has better access to blood, whereas unfortunately, ligaments do not.

Most ankle injuries – roughly 80 percent of cases – require no surgical intervention. Foot and ankle surgeons will always choose the most conservative treatment for the best long-term outcomes for a patient. If just the outer ligament is injured, we can typically reduce pain and swelling with a combination of ice, wraps and rest to lessen the chance of further tearing the ligament.

The other 20 percent of patients might have initially neglected their injury, and because they did not seek immediate care, what began as a grade one, may further develop into a more severe situation or chronic ankle instability that possibly requires surgery. 

Sprains not adequately rehabilitated, untreated, or repeatedly exacerbated can cause chronic ankle instability—a condition marked by persistent discomfort and a giving way of the ankle from stretched or torn ligaments. Proper rehabilitation and treatment are needed to strengthen the muscles around the ankle and retrain the tissues within the ankle that affect balance to help prevent further sprains or injuries. Depending on the degree of instability and lack of response to nonsurgical therapies, surgery may be required.

When asked “why my ankle sprain won’t heal,” the answer is simple: it will heal. It takes time, patience, and following your doctor’s instructions. The best thing a patient can do is to be seen by a Rothman Orthopaedics foot and ankle specialist and begin care for the injury soon after it occurs. 

Dr. Reeves is a board-certified Podiatric Foot & Ankle Surgeon, and provides comprehensive care for all ages and conditions affecting the foot and ankle. He sees patients in Lake Mary and Lake Nona FL. For more information, click here.


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