There is a tendency for the heel to roll inwards and create stress on the outside ligaments when the foot lands in an awkward manner. An ankle sprain occurs if this stress is severe. A sprain is actually a tear that occurs in the outer supportive ligaments of the ankle. As these ligaments are stretched, a critical point is reached beyond which ligaments do not return to their normal elastic function and a tear of the ligament occurs. Sprains can range from the relatively minor to those where the ligaments are completely torn and the ankle can be quite loose.
Symptoms of an ankle sprain include:
• Swelling of the ankle
• Bruising on the outer side of the ankle
Orthopedic surgeons specializing in foot and ankle conditions can diagnose ankle sprains during a physical exam and with the use of x-rays if the pain is severe.
The classic treatment for an ankle sprain is what is referred to as the Rice Program:
This treatment is designed to decrease the inflammation and swelling of the ankle associated with the sprain. The Rice Program by itself will not heal the ligaments. In order for the ligaments to heal, the ankle needs to be immobilized with either a cast or a boot. For minor sprains, a brace can be applied to the ankle. Walking is permitted during this recovery process, allowing the ankle ligaments to heal.
Following this period of initial immobilization, strengthening exercises are essential to regain the balance of the ankle. It is critical that the tendons and muscles on the outside of the ankle (the peroneal tendons) are strengthened. This should be done initially in a supervised exercise program.
If the ligaments have been severely torn, the ability to fine tune the ankle and prevent further sprains from occurring depends on the strength of the peroneal muscles. As the ankle turns repeatedly, the peroneal muscles weaken further.
This weakens the ability to prevent recurring sprains resulting in ankle instability. Patients with a high arch or a heel that is naturally turned in slightly are predisposed to sprains. As a result of continued rolling, turning or instability of the ankle, the ability to fine tune the foot on uneven surfaces becomes limited.
The ability to make rapid changes in the position of the foot on the ground surface is called proprioception. If this ability is diminished, the likelihood of a more severe ankle sprain occurring is increased.