What is an Ankle Sprain?

An ankle sprain occurs when the ankle’s supporting ligaments are stretched beyond their capacity and tear. Depending on the amount of ligaments torn and the complexity of the tears, the severity of an ankle sprain can vary.

There are three types of ankle sprains, all depending on severity. A grade one and mild ankle sprain occurs when the ligaments are slightly stretched, thus causing a small tear. A grade two and moderate ankle sprain occurs when the ligaments are torn but is not complete. A grade three and severe ankle sprain occurs when the ligaments are completely torn, thus causing a great deal of swelling and difficulty walking.

Ankle Anatomy

The ankle consists of two joints: the ankle joint and the subtalar joint. The ankle joint consists of three bones: The tibia, the fibula, and the talus. The tibia is the larger lower leg bone and creates the interior part of the ankle. The fibula is the smaller lower leg bone that creates the exterior part of the ankle. The talus is the small bone that exists between the tibia and fibula. The subtalar joint consists of the talus as well, and the calcaneus, also known as the heel.

The bones are covered by supportive articular cartilage. The excess space within the joint is surrounded with a membrane called the synovium. The synovium works to support the joint and produces synovial fluid, a fluid that helps the joint move smoothly and freely.

Ligaments work to hold the bones of the ankle together, thus aiding in support of the area. The ligaments in the ankle include: anterior tibiofibular ligament, lateral collateral ligament, deltoid ligaments.

The ankle is also made up of numerous tendons that work to attach muscles of the lower leg to the ankle and foot. The tendons include: achilles tendon, the flexor hallicus longus, flexor digitorum, peroneal tendons, posterior tibialis tendon, and anterior tibialis tendon.

Ankle Sprain Signs & Symptoms

There are a number of ankle sprain symptoms that vary depending on the severity of the injury. Symptoms include but are not limited to: pain during physical activity or weight bearing, pain at rest, swelling of the area, bruising, tenderness with contact, restricted range of motion, popping sensation at the time of the injury, weakness of the ankle, or feeling as though the ankle is not going to support your weight.

Causes of Ankle Sprains

There are many ankle sprain causes. The most common cause of ankle sprains is the twisting of the foot or ankle. In more severe twisting cases, the patient may recall hearing or feeling a pop. Additional causes of ankle sprains include: walking or running on an uneven surface, tripping, falling, another individual stepping on the foot, and taking action in sports or athletics that rely heavily on jumping.

Risk Factors

Many factors can put you at risk for a sprained ankle. Ankle sprain risk factors include sports participation, uneven surfaces, previous injury to the ankle, weak physical condition, and improper shoes. When participating in sports, you are more at risk to twist the ankle from jumping or from direct contact with others. Uneven surfaces can cause ankle twisting and can lead directly to sprains. When having a previous injury to the ankle, the ankle is weakened and more prone to re-injury. As far as footwear goes, wearing improper shoes that either do not fit or that do not properly support the feet and ankles can make the ankle more vulnerable to injury.

When to See a Doctor

It is important to know when to see a doctor in the event of an ankle sprain injury. If you recall falling or twisting your ankle and are experiencing pain, swelling, bruising, or difficulty walking, you should seek the care of a doctor.


How are ankle sprains diagnosed? Your doctor will be the one to diagnose your ankle sprain. First, they will administer a physical examination of the foot and ankle to identify common signs and symptoms of the injury. In doing so, they will be able to identify the ligaments that are injured as well as recognize the limited mobility of your ankle.

Soon after the physical examination, your doctor will most likely order you to have an x-ray or another form of image testing. An x-ray will provide images of the bone. A stress x-ray may be used in addition to a regular x-ray, for it shows whether the injury is caused by injured ligaments. An MRI may also be administered in order to examine other structures in the area and if the pain of the sprain continues for longer than six to eight weeks.

Ankle Sprain Treatment Options

Ankle sprain treatment options come in the forms of both nonsurgical and surgical. Depending on the severity of the injury, treatment options can vary.


In terms of nonsurgical treatment, it is important to eliminate any weight bearing on the area. It is important to limit physical activity that can cause any additional stress to the injury. This can be achieved through the use of crutches, splints, or braces to assist in the healing process of the injury. Applying ice can also help reduce swelling as well as the wrapping of the ankle in a compression bandage. Additionally, elevating the ankle when sitting or laying down can help ensure that the ankle is raised higher than your heart to further reduce swelling. Anti-inflammatory drugs such as ibuprofen and naproxen can also reduce pain and swelling of the ankle.


Surgical treatment for ankle sprains is not common. Surgery is administered to injuries that do not heal from nonsurgical treatment methods and for pain that persists for months after the completion of rehabilitation. Arthroscopic surgery occurs when using a small camera to see the inside of the joint. When using small instruments, the doctor will remove any pieces of bone, cartilage, or parts of the ligament that may be problematic to mobility. Repair and reconstruction surgery occurs when the doctor repairs the torn ligaments with stitches.

Physical Therapy for Ankle Sprains

Physical therapy is important and effective in improving flexibility, strength, and mobility of the injury. During physical therapy sessions, many exercises will be taught and demonstrated to aid in your recovery process. Through early motion, strengthening exercises, balance training, and endurance and agility exercises, physical therapy will help restore the health of the ankle. Physical therapy will help prevent stiffness, strengthen muscles and tendons, improve balance, and progressively increase range of motion.

Ankle Sprain Prevention

It is important to take precautionary prevention strategies to avoid ankle sprains. When exercising, be sure to warm up your muscles and to wear proper and supportive footwear for the activity. Always pay close attention to the ground when walking or running to ensure that you do not trip or fall on uneven surfaces. Finally, you should be sure to maintain strength in your ankle by performing strengthening exercises regularly so that your ankle will be able to support a wide range of physical activity.

For more information about ankle sprain treatment in Nassau County and Long Island, contact Hicksville Physical Therapy today.

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