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How many times have you rolled your ankle on a rock, shrub, hole in the ground, or maybe even your own foot, much to your dismay? Probably far too many to count! It isn’t hard to do, especially here in Wyoming with the abundant riverbeds, streams, and mountainous terrain. Most of the time, you can probably walk off the minor injury, but sometimes, the pain lasts longer than you thought it would. So how do you know when to be concerned and what to do to take care of yourself? The following are guidelines from Memorial Hospital of Converse County (MHCC).

Classify the Injury and Severity

First of all, what is a sprain? Depending on the severity of the injury, it is an overstretch or tear of a ligament, which is a structure that connects one bone to another. There are two main classifications of ankle sprains—high and low.

High ankle sprains occur within a ligament called the syndesmosis—which connects the tibia and fibula—the two bones of the lower leg. High ankle sprains are less common than low ankle sprains and most often occur when the foot is placed in a position in which it is points up and rotates externally while the ankle rolls inward. This position typically occurs in plant and pivot sports.

Low ankle sprains include medial and lateral ligament sprains, which are on the inside and outside of the ankle, respectively. Out of the three types of ankle sprains, lateral ligament sprains are the most common since these ligaments are weaker and more susceptible to overstretching than the medial ligaments. When you “roll your ankle or foot,” the anterior talofibular ligament (ATFL) on the outside of your ankle is susceptible to sprains, because your foot flexes and rolls in, causing this ligament to stretch.

There are three grades of ankle sprains; Grade I is the least severe, while Grade III is the most severe. Grade I sprains are overstretching and tiny tears within the ligament, while Grade II sprains are partial tears of a ligament and Grade III sprains are tears that span the entire ligament. The amount of instability and pain rises with each increase in sprain grade, and you may be able to gauge the type and grade of the sprain you have based on these factors. However, you should consult a healthcare professional to receive an official diagnosis, possible imaging for fractures, and instruction on how to proceed.

Rest, Ice, Compression, and Elevation

It is normal for your ankle to swell when sprained, but it is important to adequately rest and decrease the swelling so you can begin to restore function quickly.

• As soon as you suspect an ankle sprain or are diagnosed with one, apply ice to the area for 15 to 20 minutes at a time a few times per day. You may need to place a towel or pillowcase between the ankle and ice to prevent an ice burn.

• Elevate your ankle above heart level to decrease swelling.

• Compress the ankle with a wrap to push the swelling out.

• Rest the ankle. Depending on the sprain severity, you may need crutches or a boot to eliminate weight bearing.

Rehabilitation

See a physical therapist for treatment early on in your injury. This is important, because lack of rehabilitation can create long-term deficits that lead to chronic ankle instability (CAI) and can cause re-sprains. Rehabilitation exercises focus on preventing early range of motion loss, progressing range of motion as swelling and pain decrease, restoring strength, improving balance, and integrating functional and recreational activities back into your routine.

Red Flags

Typically, ankle sprains resolve with proper rest and rehabilitation. However, there are some warning signs that your ankle may not be healing properly or that there may be another health concern. A couple warning signs include pain level not improving, and ankle instability persisting. You may also continue having swelling or bruising that does not resolve in a couple weeks. Sensations in the leg, foot, and ankle such as numbness, tingling, burning, or pins and needles are another red flag warranting consultation from a healthcare provider.

MHCC is here to help you get back “on your feet” if you, a family member, or a friend experiences a sprain. Do not hesitate to call our healthcare team at (307) 358-2122 if you have any questions or think you may have sprained your ankle.