The ankle sprain is the most common sports injury and generally occurs in activities which involve running and jumping (i.e. basketball, soccer and volleyball).
Ankle sprains are generally classified into 3 categories:
• Grade I - These involve a stretched ligament with minimal swelling and pain.
• Grade II - A partial tear of the ligaments occurs with moderate pain and swelling.
• Grade III - Complete tear of the ligament with instability, frequent and disabling pain and marked edema (swelling) and discoloration.
Most patients will give a history of a “twisting” injury and will have difficulty weight bearing initially on the injured foot. Swelling will appear immediately or gradually over 3 to 4 hours. Other patients report they are “apprehensive” about bearing weight on the involved foot.
A physician will usually order X-rays to confirm or rule out a broken bone and to evaluate for joint instability.
Generally, grade I or II sprains are treated functionally with a brief period of controlled immobilization. Icing, elevation and compression are of paramount importance during the recovery period. These components will aid in the reduction of the inflammatory response. Patients are frequently referred to PT for strengthening and preparation for return to activity. Grade I and II ankle sprains tend to recover within a short time frame and progress is usually noted within 2 weeks.
In a grade III sprain, casting or surgical repair is considered depending upon the severity of the injury. A grade III ankle sprain will take a longer period of time to heal depending upon the severity of the injury. With a strong rehabilitation program, through carefully undertaken physical therapy, patients may gradually resume normal activities over the span of a 6 week period.