A sprained ankle occurs when you roll or twist your foot inward or outward. Simple causes of ankle sprains are uneven surfaces like cracks in a sidewalk, stepping unexpectantly in a hole, or while playing sports and stepping on someone’s foot.

An inward sprain is most common which stresses the anterior talofibular ligament and/or the calcaneofibular. While inward ankle sprains are the most common, outward sprains do occur stressing the deltoid ligament. These sprains can be more severe though because of the tensile strength of that ligament. High ankle sprains not only include the ligaments of the ankle and foot, but also include the strong fibrocartilage between the tibia and fibula. These type of ankle sprains usually come from planting and twisting injuries.

Sprains are usually graded based on severity.

• Grade I sprain is a stretching or slight tearing of the ligaments with slight stiffness, swelling, and mild tenderness.
• Grade II sprain is more severe with tearing of the ligaments with moderate swelling and bruising. It can be difficult to walk on this type of ankle sprain.
• Grade III sprain is a complete tear of the ligament(s). There will be severe swelling and bruising. Walking is very restricted and sometimes will need assistance from crutches.

A visit with one of our physical therapists can help to diagnose and treat all types and grades of ankle sprains. Depending on the severity of the sprain, we may refer you to an orthopedic surgeon or podiatrist for x-rays or MRI to assess the severity of ligament damage. In some extreme cases, surgery is warranted. Physical Therapy treatment likely would include modalities like ice, range of motion exercises, ankle strengthening, and proprioceptive training to restore ankle muscle coordination to prevent future injury.

Brian Cragun, PT, DPT