The #1 Sports Injury: Sprained Ankle

By: Daniel W. Guehlstorf, MD

Nearly everyone will experience an ankle sprain sometime in their life. It is the single most common sports injury. The American Family Physician medical journal states, “Acute ankle injury is one of the most common musculoskeletal injuries in athletes and sedentary persons, accounting for an estimated 2 million injuries per year and 20 percent of all sports injuries in the United States.” Although most sprained or twisted ankles heal quickly with no long-term problems, in some cases, definitive medical treatment is essential.

Most common ankle sprains occur when stepping down on an uneven surface. In sports such as basketball or soccer, that uneven surface is usually another competitor’s foot. Another related injury is called a high ankle sprain, which occurs when the ligaments between the tibia and fibula are strained due to twisting, trauma or force.

Twisted Ankle. Now What?

A person with an ankle injury should seek medical attention when the pain is so severe that they have difficulty bearing weight on that foot, have an extreme amount of swelling, or the ankle is not getting better within a couple of weeks.

Ankle sprains are graded on a scale from one to three. A grade one sprain is when the ligaments are stretched but not torn. Grade two is a partially torn ligament. Grade three is a completely torn ligament.

Grade two and three sprains are usually so painful that weight bearing causes significant pain and swelling. The vast majority of these will get better without surgery, but they do require treatment to prevent further injury and to prevent long term instability.

Coping with an Ankle Ligament Tear

Ligaments take a minimum of six weeks to heal. They might not be painful for six weeks, but our treatment goal is to protect that ligament for at least that length of time so it can heal to normal strength and at the correct ligament length. Ankle ligaments almost always heal themselves, but if the ankle is not protected after a ligament tear, the ligament might heal as stretched or elongated, which causes the ankle to roll easily after the injury is healed.

If someone ends up with an unstable ankle that rolls easily, they usually need to wear a brace on that ankle or have the ligaments reconstructed. Patients that receive adequate treatment following an ankle sprain rarely need surgical intervention.