Sprain describes an injury to a ligament. All sprains are graded on a scale of I to III. Grade I injuries are mild and do not involve any tearing of ligament fibers. Grade II sprains result in the tearing of some, but not all, of a ligament's fibers. Grade III tears are complete tears of the ligament. Ankle sprains occur in athletes of all ages, but teenage athletes are more likely to experience severe injuries than younger athletes.
Understanding the Ankle's Structure
The ankle has four major ligaments that help hold it in place. The anterior talofibular (ATFL) and calceaneofibular (CFL) ligaments are on the outside and keep the ankle from rolling outward. The large deltoid ligament is on the inside and keeps the ankle from buckling inward. The syndesmotic ligament is actually a group of smaller ligaments that connect the two bones of the leg near the ankle, which holds the ankle together at the bottom of the leg.
Causes of Ankle Sprains
Ankle sprains are caused by forces on the foot that stress the ligament to the point of injury or failure. Sprains most often occur when an athlete missteps and "rolls" his or her ankle. One will feel immediate pain on the outside of the ankle and varying degrees of swelling and bruising, depending on the severity of the injury. Grade I sprains are mild enough that an athlete often may continue playing only to feel more sore after the game. In Grade II/III injuries, the athlete usually cannot continue playing, and his ankle will swell and bruise over the first one to three days. Crutches are often needed initially. Syndesmosis sprains, though less common, are usually more severe and typically occur when the ATFL/CFL ligaments are also sprained.
Treating Your Injury
Initial treatment for all sprains is the same: Rest, Ice, Compression and Elevation, otherwise known as the RICE method. Thereafter, a sports medicine physician should be consulted to evaluate any significant injury. Often, fractures and other ankle injuries appear to be a sprain. An X-ray may be required to identify fractures that mimic ankle sprains. Control of swelling and pain treatment often involves physical therapy to speed recovery and ensure return of the player's strength and balance. However, only five percent of all ankle sprains result in an injury that requires surgical treatment. This usually involves a delayed reconstruction if the ankle becomes unstable and repeatedly sprains.
Ohio Riverside Sports Medicine is the official sports medicine provider of the Columbus Crew. Each month, physicians of Ohio Riverside Sports Medicine at the Ohio Orthopedic Center of Excellence write articles on performance enhancement and injury prevention and share them with the community.