Ankle Sprain

What Is an Ankle Sprain?

An ankle sprain occurs when the ligaments that connect the bones in your ankle are stretched or torn, usually from rolling, twisting, or turning the ankle awkwardly. Ligaments are tough bands of tissue that stabilize joints by connecting bones together.

Ankle sprains are very common among runners, especially those who run on uneven terrain, trails, or in the dark. The injury typically occurs when the foot rolls inward (inversion sprain) or outward (eversion sprain), with inversion sprains being more common. The severity can range from mild stretching to complete ligament tears, which significantly impacts your ability to run and walk.

Symptoms and Causes

Symptoms of ankle sprains

Common symptoms of an ankle sprain include:

• Pain: Sharp pain at the time of injury, especially when moving the ankle
• Swelling: Rapid swelling that develops within minutes or hours
• Bruising: Discoloration that may appear hours or days after injury
• Tenderness: Soreness when touching the affected area

Instability: Feeling that the ankle may give way

• Difficulty walking: Pain and instability affect normal gait
• Stiffness: Reduced range of motion in the ankle
• Popping sensation: Some people hear or feel a pop at the time of injury

Symptoms can vary depending on severity. Mild sprains may only cause discomfort, while severe sprains can make it impossible to bear weight on the affected foot.

Ankle sprain causes

Ankle sprains typically occur due to:

• Rolling the ankle: Foot turning inward or outward awkwardly
• Uneven surfaces: Running on trails, grass, or uneven terrain
• Weak ankle muscles: Insufficient strength in muscles supporting the ankle
• Previous injury: Incompletely healed ankle sprains are more prone to re-injury
• Poor balance: Reduced proprioception increases risk
• Improper footwear: Shoes that don’t provide adequate ankle support
• Fatigue: Running when muscles are tired
• Sudden direction changes: Quick changes in direction during running
• Running in the dark: Reduced visibility increases risk of missteps
• Biomechanical issues: Foot structure or gait abnormalities

Risk factors

Several factors increase your risk of developing an ankle sprain:

• Previous ankle injury: History of ankle sprains significantly increases recurrence risk
• Weak ankle muscles: Insufficient strength in muscles supporting the ankle
• Poor balance: Reduced proprioception and balance
• Running on uneven surfaces: Trails, grass, or uneven terrain
• High-impact sports: Activities involving jumping or quick direction changes
• Improper footwear: Shoes without adequate support
• Fatigue: Running when muscles are tired
• Ligament laxity: Naturally loose ligaments
• Age: Balance and proprioception may decrease with age

Complications of ankle sprains

If not properly treated, ankle sprains can lead to:

• Chronic ankle instability: Ongoing feeling that the ankle may give way
• Recurring sprains: Repeated ankle injuries
• Arthritis: Long-term joint damage can lead to osteoarthritis
• Persistent pain: Ongoing discomfort that affects daily activities
• Reduced performance: Inability to train at desired intensity
• Compensation injuries: Altered gait patterns can cause problems in knees, hips, or back
• Tendon damage: Associated tendon injuries

Early and proper treatment significantly reduces the risk of these complications and improves recovery outcomes.

Diagnosis and Tests

How you can diagnose ankle sprains

Initial self-assessment can help identify an ankle sprain:

• Mechanism of injury: Rolling or twisting the ankle
• Immediate pain: Sharp pain at the time of injury
• Rapid swelling: Swelling that develops quickly
• Bruising: Discoloration that may appear later
• Difficulty bearing weight: Pain when standing or walking
• Instability: Feeling that the ankle may give way
• Tenderness: Soreness when touching the affected area

If you cannot bear weight, hear a pop, have severe pain, or suspect a fracture, seek medical attention immediately.

Tests that can help diagnose ankle sprains

Healthcare professionals may use several diagnostic methods:

• Physical examination: Palpation of the ankle to identify tender areas and assess stability
• Range of motion assessment: Evaluates flexibility and identifies limitations

Stress tests: Checks ligament integrity and ankle stability

• X-ray: May be used to rule out fractures
• MRI: Detailed imaging for severe cases or when diagnosis is unclear
• Ultrasound: May be used to visualise ligament damage

Professional diagnosis ensures appropriate treatment and rules out fractures or more serious injuries.

Management and Treatment

How do you heal an ankle sprain quickly?

Effective treatment follows the RICE protocol initially:

• Rest: Avoid activities that cause pain. Use crutches if walking is painful
• Ice: Apply ice packs for 15-20 minutes every 2-3 hours for the first 48 hours
• Compression: Use an elastic bandage or compression sleeve to reduce swelling
• Elevation: Keep the ankle elevated above heart level when resting

After the initial 48-72 hours:

• Gradual weight-bearing: Begin putting weight on the ankle as tolerated
• Range of motion exercises: Gentle ankle movements to restore flexibility
• Strengthening exercises: Progress to resistance exercises for ankle muscles
• Balance training: Proprioception exercises to improve stability
• Physical therapy: Professional guidance for proper rehabilitation
• Bracing: Ankle braces may provide support during recovery

Ankle sprain recovery time

Recovery time varies based on severity:

• Grade 1 (Mild): 1-2 weeks. Minor ligament stretching
• Grade 2 (Moderate): 3-4 weeks. Partial ligament tear requiring more extensive rehabilitation
• Grade 3 (Severe): 4-6 weeks or longer. Complete ligament tear, may require surgical intervention

Factors affecting recovery:

• Severity of the initial injury
• Adherence to treatment and rehabilitation
• Previous injury history
• Age and overall health
• Time before seeking treatment
• Addressing underlying causes (weak muscles, balance)

Return to running should be gradual, starting with walking, then light jogging on flat surfaces, before gradually increasing distance and intensity. Balance and strengthening exercises are crucial for preventing recurrence.

What Could Help

Several products and tools can aid in your ankle sprain recovery:

• Ankle braces: Ankle braces provide support and stability during recovery
• Compression sleeves: Ankle compression sleeves can help reduce swelling
• Ice packs: Reusable ice packs help manage inflammation and pain
• Resistance bands: Resistance bands are useful for strengthening exercises
• Balance boards: Balance boards help improve proprioception and stability
• Crutches: Crutches may be needed for severe sprains
• Kinesiology tape: Kinesiology tape may provide support during recovery

Always consult with a healthcare professional before using recovery tools, especially if your injury is severe.

Prevention

How can I prevent an ankle sprain?

Preventive measures significantly reduce your risk:

• Ankle strengthening: Regular exercises targeting ankle muscles
• Balance training: Proprioception exercises to improve stability
• Proper footwear: Wear running shoes with adequate ankle support
• Avoid uneven surfaces: Be cautious when running on trails or uneven terrain
• Gradual progression: Follow the 10% rule – increase weekly mileage gradually
• Warm-up properly: Always include dynamic warm-up before running
• Address previous injuries: Complete rehabilitation from previous ankle sprains
• Run in daylight: Better visibility reduces risk of missteps
• Listen to your body: Address minor discomfort before it becomes a full injury
• Cross-training: Include activities that improve balance and strength