What should you know about ankle sprains?
Ron Handshoe, MSPT
Regional Manager – Mt. Sterling, KY
With Basketball season in full stride and most sports now playing year round, it seems like a good time to discuss ankle sprains and what to do if you have suffered one.  There are more than 3 million cases of ankle sprains reported each year in the US.  Ankle sprains occur when the ligaments that stabilize the ankle joint are stretched and/or torn due to an aggressive inward or outward turning of the foot.  Most sprains are the result of the foot turning inward such as when stepping on an uneven surface or landing wrong while walking, running or jumping.
Ankle sprains can range from very mild to severe, even resulting in what is known as an avulsion fracture of the fibula.  The fibula is the smaller, non-weight bearing long bone on the outside of your leg.  Because ankle sprains vary in severity there is a grading system put in place for MDs to correctly diagnose.  Those grades are as follows:


  • Grade 1 (Mild) Sprain:  Light over stretching of the ligaments with microscopic tears.  Your ankle will have some soreness and minimal swelling noted.
  • Grade 2 (Moderate) Sprain:  Results in partial, but not complete tears of the ligaments that stabilize the ankle joint.  You will have swelling and bruising noted in the foot and ankle along with moderate to severe tenderness to touch.
  • Grade 3 (Severe) Sprain:  This occurs when there has been a complete tear of one or more of the ligaments that stabilize the ankle.  You will more than likely have excessive swelling and bruising.  The tenderness of the ankle will be severe.

Always remember the RICE protocol following an ankle sprain:
R = Rest
I = Ice for 15-20 minutes 3-4 times/day
C = Compression such as an ace wrap (not too tight)
E = Elevation is important to help decrease the swelling
It is important to see your physician if you have suffered an ankle sprain that has swelling, bruising and is painful with walking as they may need to perform x-rays to rule out a fracture and determine the next course of action.  More than likely your Physician will send you to Physical Therapy.
Physical Therapy is very important to help you return to work, sports or recreation as soon and safely as possible.
Your Physical Therapist will start by helping decrease swelling and pain.  At the same time they will educate you on important exercises to regain range of motion of your ankle.  As ROM begins to return and pain decreases, the Physical Therapist will progress you to strengthening exercises in order to restore what you have lost as a result of the sprain.  As you become more comfortable with placing weight on the injured leg, you will be instructed on balance activities to perform.  These activities improve the proprioception (knowing where the ankle is in space) of the joint allowing you to decrease the possibility of a future ankle sprain.
Depending on the severity of the ankle sprain, rehabilitation can take anywhere from 2 weeks to 12 weeks.  This is why it is important to seek a medical provider if you feel the sprain is beyond a slight injury.  Treatment can help you recover faster with less pain and decrease the possibility of future sprains and arthritis formation.