Ankle Sprains Simplified

At some point in our lives, we are likely to experience an ankle sprain. Some are mild while others are severe. There are multiple diagnoses and grades of sprains. The goal of this post is to simplify it a bit.

First, what is a “sprain”? Often confused with “strain”, a sprain is an injury to a ligament (a strain is an injury to a muscle). Ligaments are band or rope-like structures that connect one bone to another bone. Consequently, ligaments will be found at our joints where bones come together. They contribute to the passive stability of our joints by preventing the joints moving in unwanted or unnatural ways. For example, the knee has four major ligaments (ACL, PCL, LCL, MCL), each stabilizing the joint in a different way. The ankle has several ligaments on both sides that crossover the joint to help prevent the ankle from rolling inward or outward excessively. Ankle sprains occur when these ligaments are injured.

There are three general grades of sprains: one, two, and three. Each grade indicates a different level of severity, with one being mild and three being the most severe. Grade one is an irritated and inflamed ligament without major structurally damage. These injuries can be painful and limiting for a few days, but there is generally little swelling or bruising. Grade two sprains involve some structural damage to the ligaments (partial, micro tearing) and result in some swelling and bruising around the area. These will take longer to fully heal, maybe even a few months for some people. Grade three sprains are more severe and are often associated with complete tears of the ligaments. These are associated with highly traumatic injuries and may require surgery to fix.

In general, the ankle can be sprained in three areas. The most common in the inversion ankle sprain where the foot rolls in and the ankle goes out. This results in damage and pain to the outer ligaments that connect the ball to the foot and ankle. Medial ankle sprains occur when the foot is forced outward and the ankle goes in, so the opposite of an inversion sprain. This injures the ligaments on the inside of the ankle. A high ankle sprain occurs when there is an injury to the ligaments that hold the shin bones above the talus (ankle bone). This usually occurs when the talus rotates violently within the space and pushes out on the balls, creating a separation when the bones meet. This injury generally takes longer to heal and return to sport than inversion and medial sprains. Check out my amazing illustrations below.

My goal with this post was to try simplifying the diagnoses of different ankle sprains. I hope to build off this post and discuss different treatment and injury prevention strategies.

Thanks for reading.


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