Health Topics for Sports Medicine

Department of Orthopaedic Surgery

UI Family Care

Ankle sprains

A sprain is a painful stretching or tearing of a ligament, which is a band of tough, fibrous tissue connecting bones at a joint. The ankle is one of the most easily sprained joints. Ankle sprains are usually caused by twisting the ankle.

Most of ankle sprains result when the foot twists inward. The outside ligaments are then stretched or torn. The ligaments on the inner side of the ankle are affected when the foot twists outward.

There are 3 grades of sprains:

• Grade 1 - With a first-degree sprain there is stretching and minimal tearing with mild pain and swelling. No bruising or loss of function exists. Recovery time is 4 to 6 weeks.
• Grade 2 - With a second-degree sprain, a tearing sensation, pop, or snap is felt. Swelling and tenderness exist. Bruising begins 3 to 4 days after the injury and walking may be difficult because of a mild looseness of the joint. Recovery time is 4 to 8 weeks.
• Grade 3 - With a third-degree sprain the joint may slip out of place and then back in. Massive swelling, severe tenderness, and instability exist. Walking may not be possible and surgery may be necessary. Recovery time is 6 to 12 weeks.

Severe ankle sprains need medical care and should be X-rayed to rule out a possible fracture. Treat simple ankle sprains with RICE, which stands for rest, ice, compression and, elevation.

Ice the injury as soon as possible. Apply to the ankle a cloth- covered ice pack to the affected area for no more than 20 minutes at a time, 4 to 8 times a day. Rest the affected area, do not use or bear weight (standing, walking, etc.), until evaluated by provider. Stay off your feet. Crutches are advised for the first few days even with mild sprains.

Exercising before the sprain has healed may worsen the sprain and increase the chance of re-injury. Rest the ankle until it is pain free. The healthcare provider may suggest using an elastic bandage to the area to help reduce swelling. The affected part should be elevated so it is 12 inches above the heart to help reduce swelling.

Take medications, such as aspirin, acetaminophen, or NSAIDS, as directed and approved by your healthcare provider. Aspirin or medicines that have aspirin in them should not be given to anyone younger than 18 years of age. Taking aspirin is a risk for a serious illness called Reye's syndrome.

Non-steroidal anti-inflammatory drugs (NSAIDs) should be taken with food or milk to prevent stomach upset. NSAIDs should not be taken by anyone who has been diagnosed with asthma, ulcer disease, or a bleeding disorder. Taking NSAIDs increases the risk of bleeding with trauma, dental work, surgery, or if taking blood thinners (anticoagulants).

Acetaminophen should not be taken by anyone with known liver or kidney disease. Do not drink alcohol when taking more than 1 dose of acetaminophen.

Last Reviewed 2005

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

HIL File SPOR3204.rf2 VRS# 7405 Data Version 7.0 Copyright 1999-2000, 2003 McKesson Health Solutions LLC. All rights reserved.