Most ankle sprains come from accidently inverting the foot. When you invert the foot, you twist the ankle inward, landing on the outside bone of the ankle. This causes tearing and stretching of the ligaments that support the outside part of the ankle. You will have increased pain, bruising, and swelling of the outer part of the ankle and will have a hard time walking on the foot without pain.

Grades of Ankle Sprains

Ankle sprains come in three different grades. The grade of ankle sprain you have depends on how severely the ligaments are damaged and how much pain you are experiencing. Here are the 3 grades of ankle sprain you might expect if you twist your ankle:

  • Grade I Ankle Sprain. When the ankle is injured and you sustain a grade I ankle sprain, it means that the ligaments are just stretched or are partially torn during the injury. There will be some swelling and tenderness but it will easily be relieved with anti-inflammatory medications, an ACE wrap and ice to the affected area. You will be able to bear weight on the foot and will be able to walk around with only a little bit of pain. The ankle will be completely stable when the podiatrist tries to apply stress to the strained area.
  • Grade II Ankle Sprain. In such cases, there is a tear of at least one ligament, usually the anterior talofibular ligament (which connects the long fibula bone with the talus in the foot) and you will experience a moderate amount of swelling and pain. Because ligaments have been torn, there may be some bruising around the outside of the ankle and you will limp when you try to walk on the ankle. The side of the ankle will be very tender to the touch and you will have pain on putting weight on the foot.
  • Grade III Ankle Sprain. When this happens, a ligament has been torn and the ankle is unstable. There is severe swelling that goes up the leg and severe bruising. You will be unable to bear weight or walk on the ankle because of the pain and because a ligament that normally supports the ankle has been disrupted. When the podiatrist checks the ankle ligaments for stability, the ankle will not hold up under stress.

Treatment of Ankle Sprain

No matter how injured your ankle is, you will need to rest the ankle, apply ice and probably will have to put an ACE wrap on it to reduce swelling and to make the ankle feel more stable. Nonsteroidal anti-inflammatory medications such as ibuprofen and naproxen sodium can be used to reduce inflammation and help ease your pain.

In severe cases, you may have to have your ankle casted or have an ankle boot placed on the ankle in order for the ligament to heal. Crutches might be needed if you can’t bear weight on the ankle so that you can get around. You should try to keep the ankle up as much as possible because swelling tends to happen from gravity on the tissues when you are upright. An ACE wrap will help with some of the swelling and should be on your ankle whenever you are up on the leg.

Surgery is rarely necessary after an ankle fracture. The ligament usually heals on its own but this can take several weeks, especially with a grade III ankle sprain.

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