Seattle Ankle Sprain & Pain Doctor

Sprain

What is an ankle sprain?

An ankle sprain is the most common type of ankle injury. It usually involves an inversion twist of the foot that injures the outer ligaments of the ankle. It usually occurs unexpectedly with an awkward step off a stair or curb or a trip or step onto an uneven surface. When the outer ligaments are sprained, they can tear fully or partially. Sprains are generally graded as mild, moderate, or severe. Mild sprains may not cause ligament damage while severe sprains involve ligament rupture. With severe ankle sprains there is always the concern that the same twisting injury can fracture the ankle bones, which presentation can appear similar to a sprain. Therefore, x-rays are needed to rule out this possibility. Treatment for severe sprains involves a brace or cast. Any ankle injury that does not resolve in a few days should be evaluated by a foot and ankle specialist.

How common is an ankle sprain?

It is estimated by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMSD) that an ankle sprain occurs at a rate of 1 per minute or 850,000 times per year in the US.

What should I do if I sprain my ankle?

Self directed treatment for an ankle sprain is R.I.C.E.: rest, ice, compression and elevation. This should be started as soon as possible. after the injury. Resolution of the symptoms will take a few days for a mild sprain to 6-8 weeks for severe sprains with ligament tears. If you have sprained an ankle and it does not improve in a day or two, you should have your ankle evaluated by a foot and ankle specialist.

What do I do if my ankle sprain is not healing?

In cases where the ankle is still painful and swollen after 2 months, further tests need to be performed to see if there is a hidden injury that was not initially diagnosed. Physical therapy for ankle sprains is usually indicated in patients that place high demands on their ankles. Rehabilitation generally concentrates on balance, range of motion, and soft tissue modalities to reduce swelling and sensitivity to the injured part.

What could prevent prevent my ankle from responding to rehabilitation? 

A little diagnostic detective work is needed in this setting to figure out why the ankle is not responding. There are many possible reasons for this scenario: (1) The ankle ligaments did not heal properly and the ankle is now unstable; (2) There may have been an undiagnosed fracture. This can be on the outer bone (fibula) or within the ankle itself (osteochondral or ankle joint surface fracture); (3) There was an undiagnosed injury to the lower ankle joint (subtalar joint); (4) Adhesions formed in the ankle joint that are still causing irritation to the joint.

With any of these possible problems causing prolonged symptoms, you may need to undergo a comprehensive foot and ankle examination along with a possible CT, MRI, or ankle stress examination to correctly diagnose the problem.

Will I need surgery?

If you have sprained your ankle for the first time...relax, surgery is rarely indicated. Conservative treatments are generally tried first and consist of: anti-inflammatories, ankle bracing, physical therapy, and time. For patients with a history of multiple ankle sprains and a feeling of weakness to the ankle, bracing may not help. These situations may require surgery to stabilize and tighten up the damaged ligaments.

Other problems that can cause issues after an ankle sprain are chip fractures or ankle adhesions that may require Arthroscopy of the ankle.

The persistent ankle sprainer that has been twisting their ankles for years may eventually require surgery since end stage ankle arthritis can develop due to permanent damage to the joint surface. Ankle Fusion or Ankle Replacement  maybe the best options when ankles reach this stage. 


Contact us to make an an appointment for your ankle sprain today.  We are your Seattle area ankle injury doctor for sprains and many other foot injuries from Bothell to Smokey Point and Lynnwood to Arlington. 

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