Best Sprained (Twisted) Ankle Treatment in Delhi, India

A sprained ankle is a common injury that occurs when the ligaments in the ankle are stretched or torn, typically due to the ankle being twisted or turned in an unnatural way. Ligaments are tough bands of tissue that connect bones to one another and provide stability to joints. Ankle sprains can range from mild to severe, depending on the extent of the ligament damage.

Ankle sprains can be categorised based on severity, as well as the direction of the force that caused the injury and the specific ligaments involved.

Based on ligament Involved

• Inversion (lateral) ankle sprain: This is the most common type of ankle sprain, occurring when the foot rolls inward, stretching or tearing the ligaments on the outside of the ankle.
• Eversion (medial) ankle sprain: Less common than inversion sprains, this type occurs when the foot rolls outward, stretching or tearing the ligaments on the inside of the ankle.
• High (syndesmotic) ankle sprain: This type of sprain affects the ligaments above the ankle joint, known as the syndesmosis. It typically occurs when the foot is forcefully rotated outward, leading to injury to the ligaments connecting the two bones of the lower leg (tibia and fibula).

Based on Severity

• Grade 1: Mild sprain characterised by minimal stretching or microscopic tearing of ligaments, resulting in mild pain, slight swelling, and minimal loss of function.
• Grade 2: Moderate sprain involving partial tearing of ligaments, leading to moderate pain, swelling, bruising, and decreased range of motion.
• Grade 3: Severe sprain with complete tearing or rupture of ligaments, causing intense pain, significant swelling, extensive bruising, instability, and inability to bear weight on the affected ankle.

Ankle sprains present with a constellation of symptoms that indicate ligament injury and compromised joint function:

• Pain, particularly when bearing weight on the affected ankle.
• Swelling around the ankle joint.
• Bruising or discoloration of the skin.
• Tenderness to the touch.
• Difficulty moving the ankle, including reduced range of motion.
• Instability or feeling like the ankle may give way.

Sprained ankles can result from various movements and activities that place stress on the ligaments, including:

• Sudden twisting or rolling of the ankle.
• Awkward landings after a jump or fall.
• Uneven surfaces or obstacles encountered while walking, running, or playing sports.
• Impact during activities such as contact sports or collisions.
• Repetitive stress on the ankle ligaments, common in activities involving frequent changes in direction or sudden stops.

Several factors contribute to an increased risk of experiencing a sprained ankle:

• Previous ankle injuries, which can weaken the ligaments and heighten susceptibility to future sprains.
• Participation in sports or physical activities that involve jumping, pivoting, or rapid changes in direction.
• Wearing improper footwear lacking adequate support or traction.
• Environmental conditions such as slippery or uneven surfaces.
• Anatomical factors like high arches or foot pronation (flat feet), impacting ankle stability.
• Inadequate warm-up or stretching before physical activity.
• Fatigue or muscle weakness, impairing balance and proprioception (awareness of body position).

Diagnosing a sprained ankle typically involves a two-step approach that involves physical examination and imaging tests (in some cases).

Physical Examination

During a physical examination, the physician:

• Inquires about the patient's symptoms, including the mechanism of injury, pain severity, and associated symptoms.
• Conducts an inspection of the ankle, looking for signs of swelling, bruising, and tenderness.
• Assesses the ankle's range of motion and stability by performing gentle movements in various directions.
• Performs stress tests by applying controlled pressure to different areas of the ankle to gauge pain response.

Imaging Tests

While X-rays serve as the initial imaging modality to rule out fractures, additional tests may be required for comprehensive evaluation:

• Ultrasound: Utilised to visualise soft tissues, such as ligaments, to identify tears or abnormalities.
• MRI (Magnetic Resonance Imaging): Provides detailed images of bones, ligaments, and other structures within the ankle for a thorough assessment.

Imaging tests are not always necessary, as a comprehensive physical examination suffices for diagnosis in most instances. However, if the physician suspects a severe injury, such as a fracture or ligament tear, supplementary tests may be ordered.

Here's a breakdown of treatment options based on the severity of the sprained ankle, ranging from self-care strategies to therapies, surgery, and others:

Mild Sprain (Grade 1)

• Self-care: Rest, ice, compression, and elevation (RICE method).
• Over-the-counter pain relievers: Ibuprofen (Advil, Motrin IB) or acetaminophen (Tylenol) can help alleviate pain and inflammation.
• Gradual return to activity: Once pain and swelling have subsided, gradually reintroduce weight-bearing activities while using support like ankle braces or wraps.

Moderate Sprain (Grade 2)

• All of the above self-care strategies.
• Immobilisation: In some cases, a healthcare provider may recommend using a walking boot or ankle brace to stabilise the ankle and prevent further injury.
• Physical therapy: A physical therapist can prescribe exercises to strengthen the ankle and improve range of motion, as well as techniques to reduce swelling and pain.

Severe Sprain (Grade 3)

• All of the above treatments may still apply, but with greater emphasis on professional management.
• Medical evaluation: It's crucial to have a thorough evaluation by a healthcare provider to assess the extent of the injury, which may include imaging studies like X-rays or MRI.
• Immobilisation: Depending on the severity, the ankle may need to be immobilised for a longer period with a cast or splint to allow proper healing.
• Surgery: In rare cases of severe sprains with significant ligament damage or instability, surgery may be necessary to repair the injured ligaments or reconstruct the ankle joint.

Always consult with a healthcare professional for an accurate diagnosis and appropriate treatment plan tailored to your specific injury and needs.

• Chronic instability: Repeated ankle sprains can lead to chronic instability, where the ligaments become lax and the ankle joint is more prone to further sprains.
• Joint stiffness: Inadequate rehabilitation or immobilisation can result in stiffness and limited range of motion in the ankle joint.
• Cartilage damage: Severe ankle sprains can cause damage to the cartilage within the ankle joint, leading to long-term issues such as osteoarthritis.
• Peroneal tendon injuries: The tendons on the outer side of the ankle (peroneal tendons) can become injured or dislocated during severe ankle sprains.
• Nerve damage: In some cases, ankle sprains can injure the nerves around the ankle, leading to numbness, tingling, or weakness in the foot and ankle.

• Strengthening exercises: Incorporate exercises that target the muscles around the ankle, including the calf muscles and the muscles that support the arch of the foot. This helps improve stability and reduces the risk of sprains.
• Balance and proprioception training: Practice exercises that challenge your balance and proprioception (awareness of your body's position in space), such as standing on one leg or using balance boards. This helps improve neuromuscular control and reduces the risk of ankle sprains.
• Proper footwear: Wear supportive shoes with good ankle support, especially during activities that involve running or jumping. Consider using orthotic inserts or ankle braces for additional support if needed.
• Warm-up and stretching: Always warm up before engaging in physical activity, and include dynamic stretches for the calf muscles, Achilles tendon, and ankle joint. This helps prepare the muscles and ligaments for activity and reduces the risk of injury.
• Avoid uneven surfaces: Be cautious when walking, running, or exercising on uneven terrain, as it increases the risk of twisting or rolling the ankle.
• Gradual progression: Gradually increase the intensity and duration of your activities to allow your muscles and ligaments to adapt and strengthen gradually.
• Maintain a healthy weight: Excess body weight puts additional stress on the joints, including the ankles. Maintaining a healthy weight can reduce the risk of ankle sprains and other musculoskeletal injuries.
• Proper technique: Pay attention to your movement patterns and technique during physical activities. Avoid sudden changes in direction or awkward landings that can increase the risk of ankle injuries.

How long does it take for a sprained ankle to heal?

Healing time can vary depending on the severity of the sprain. Mild sprains may heal within a few days to a couple of weeks, while more severe sprains can take several weeks or even months to fully recover.

Can I walk on a sprained ankle?

In most cases, walking on a sprained ankle is possible, but it's important to avoid putting too much weight on the injured ankle to prevent further damage. Crutches or a supportive brace may be recommended to aid mobility during the healing process.

Should I see a doctor for a sprained ankle?

While mild sprains can often be treated at home, it's advisable to see a doctor if you experience severe pain, swelling, or instability, or if symptoms persist despite self-care measures. Additionally, seeking medical attention is essential if you suspect a fracture or if you have a history of recurrent ankle sprains.

How can I prevent future ankle sprains?

Preventing future ankle sprains involves various measures, including wearing appropriate footwear with good ankle support, warming up before physical activity, strengthening ankle muscles through targeted exercises, and being mindful of your surroundings to avoid tripping or falling.

Is physical therapy necessary for a sprained ankle?

While not always required, physical therapy can be beneficial for restoring strength, flexibility, and stability to the ankle after a sprain. A physical therapist can provide personalised exercises and techniques to facilitate recovery and reduce the risk of reinjury.

Can ankle braces or supports help prevent sprains?

Ankle braces or supports can provide additional stability and support to the ankle joint, reducing the risk of sprains, especially during high-risk activities such as sports. However, they should not replace proper strengthening exercises or caution during physical activity.

Are there any long-term effects of a sprained ankle?

In some cases, individuals may experience lingering symptoms or chronic ankle instability following a sprain. This can increase the risk of future sprains and impact daily activities. Proper rehabilitation and follow-up care are essential to minimise long-term effects.

Can I drive with a sprained ankle?

Driving with a sprained ankle may be challenging, especially if it affects your ability to operate the pedals or if pain and discomfort make it unsafe. It's advisable to consult with your doctor and consider alternative transportation options until your ankle has sufficiently healed.

What are the signs that my sprained ankle is not healing properly?

Signs that your sprained ankle may not be healing properly include persistent pain, swelling, instability, or difficulty bearing weight on the affected ankle despite conservative treatment measures. If you experience any of these symptoms, it's important to seek medical attention for further evaluation and management.

Can I participate in sports or physical activities with a sprained ankle?

It's generally recommended to avoid participating in sports or activities that put stress on the injured ankle until it has fully healed. Returning to sports prematurely can increase the risk of reinjury and delay the healing process. Your healthcare provider can provide guidance on when it's safe to resume physical activities.

What should I do if I sprain my ankle again?

If you experience a recurrent ankle sprain, it's important to seek medical evaluation to determine the underlying cause and appropriate management. Your healthcare provider may recommend additional tests, treatment adjustments, or preventive measures to reduce the risk of future sprains.

Is there anything I can do to speed up the healing process?

While the healing process for a sprained ankle takes time, certain strategies may help promote faster recovery, such as following R.I.C.E. principles, adhering to prescribed rehabilitation exercises, maintaining a healthy diet, staying hydrated, and avoiding activities that aggravate the injury.

Reviewed By Dr Gaurav Govil Principal Consultant Orthopaedics & Joint Replacement on 21 Aug 2024.