The ankle is composed of four bones that make the joint stable. Ligaments, strong bands of fibrous tissue, provide stability to the joint. Sprains can occur when ligaments are overstretched in positions where the ankle experiences sudden movements that may stretch the ligaments beyond their normal range.
There are 3 grades of ankle sprains:
- Grade I (minimal)
- Minor tearing of the ligament.
- Associated with mild pain and swelling on the outside of the ankle, little or no instability, and some stiffness with walking.
- Grade II (moderate to severe)
- Moderate tearing of the ligament
- Associated with moderate pain, swelling, some instability, and some difficulty walking
- Grade III (complete or severe)
- Total rupture or tear of the ligament.
- Associated with gross instability of the joint and significant swelling.
- Pain levels are dependent on how much of the nerve fibres were affected with the sprain. If the nerve fibres are ruptured, there may be minimal pain. However, if the nerve fibres were significantly stretched but remain intact, pain levels may be very high.
With an acute ankle injury, your physiotherapist will apply PRICE principles (Protection, Rest, Ice, Compression, Elevation) in the first stage of injury. Once the swelling and pain comes under control, treatment may consist of passive joint mobilisations to regain full range of movement, deep tissue releases to break up any scar tissue, and specific functional exercises to help you return to full function.