First, a crash course in anatomy: ligaments are connective tissue that hold one bone to another bone. There are many ligaments in the foot and ankle and these are susceptible to injury. A sprain is an injury to a ligament in which the ligament is over stretched or torn. The most common mechanism of injury is an “inversion injury” in which the foot rolls inward most commonly from stepping off a curb or walking on an uneven surface. This results in pain and sometimes swelling over the affected ligament.
An X-ray is indicated if you are unable to walk on the affected ankle or you have tenderness to touch over the bony prominences of the ankle or pain along the outside of the foot or in your upper lower leg. Since many patients with ankle sprains have one of more of these signs, and X-ray is more often indicated than not.
The standard treatment for ankle sprains can be remembered with the acronym “R.I.C.E.” which stands for rest, ice, compression, and elevation. We typicaly rest the ankle by providing crutches to give the ligaments a chance to heal and gradually return the patient to weight bearing status. Ice is believed to help reduce inflammation and also helps with pain. We also usually apply a compressive ACE bandage dressing to support the area and minimize further swelling. If the ankle joint is unstable or if it appears the ligaments are torn, we may prescribe an orthopedic boot instead. Lastly, elevation decreases swelling and reduces pain and inflammation. In addition to R.I.C.E. therapy, your doctor may also determine if you need a more advance orthotic device such as an orthopedic boot to provide additional support. Anti-inflammatory pain medications such as ibuprofen are also usually recommended. Ankle sprains may take as little as a few days to recover but could take several weeks or even a month or more to regain full strength.