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Sprained Ankle or Twisted Ankle: Causes, Symptoms, Treatment, Exercises, Risk Factors, Recovery Period, Complications

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What is a Sprained Ankle or Twisted Ankle?

Sprained ankle or a twisted ankle is an injury, which occurs when the ankle is rolled, twisted or turned in an awkward manner resulting in tearing or stretching of the ligaments whose main purpose is to help in stabilizing the ankle bones together.[1] Majority of the cases of sprained ankle or a twisted ankle comprise of injuries to the ligaments on the external region of the ankle. Treatment depends on the severity of the ankle sprain. If the ankle sprain is mild, then conservative measures with over-the-counter (OTC) pain medications may suffice. If it is a severely sprained ankle, then medical attention/treatment is required.

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What Causes Sprained Ankle or a Twisted Ankle?

The situation giving rise to majority of sprained ankle or a twisted ankle is a shifting movement against your foot for example in a football tackle. While the foot will be turned inward, your ankle rolls outward. The ligaments that are outside the ankle will tear after stretching excessively. It is rare for case which the foot turning outward and the ankle rolling inward. The ligaments inside of the ankle are damaged as a result. Other causes of sprained ankle or a twisted ankle can include:

  • Falling and landing on the ankle causing it to twist can lead to sprained ankle or a twisted ankle.
  • Jumping and landing awkwardly on the ankle.
  • Walking, jogging or exercising on irregular surfaces can cause an ankle sprain.[2]

What are the Signs and Symptoms of Sprained Ankle or a Twisted Ankle?

Pain is often the reported symptom from the patients with a sprained ankle or a twisted ankle. Inversion injury causes this. In this process, the foot rolls underneath your leg or ankle. The major signs and symptoms might include:[3,4]

  • Pain upon weight bearing on the injured foot.
  • Pain upon movement of the injured foot can be a symptom of ankle sprain.
  • Swelling of the ankle.
  • Bruising of the ankle.
  • Redness and warmth.
  • Restricted range of movement is a common sign of a sprained or twisted ankle.
  • There may be a “pop” audible or felt when the ankle sprain injury occurs.

What are the Risk Factors for Sprained Ankle or a Twisted Ankle?

As stipulated above, twisting of the ankle underneath the leg is known as inversion. Some individuals tend to be predisposed by the sprains. The injuries are more common for people with hind foot varus (the posture and the general nature of the heels are turned slightly towards the inside. Turning on the ankle i.e., sprained ankle or a twisted ankle is easier in this situation.

A new sprain can be formed when one has had a history of a sprained ankle or a twisted ankle. Instability is one of the risk factors of sprained ankle or a twisted ankle in this consideration. Those who are more predisposed are those who have weak muscles, especially those known as peroneals running along the exterior part of the ankle.

  • Participating in sports such as football, soccer, basketball, and tennis increases your chances of spraining your ankle as sprained ankle or a twisted ankle is a common sports injury.
  • Previous ankle injury increases the risk of spraining your ankle again.[5]

What are the Complications Involved in Sprained Ankle or a Twisted Ankle?

Surgery is needed in rare situations for sprained ankle or a twisted ankle. Chronic instability can result due to improper rehabilitation of the ankle as noted above. Prior to further damaging of the ankle, it is to sort it with surgery or physical therapy.

How is Sprained Ankle or a Twisted Ankle Graded?

  1. Grade 1 Sprained Ankle or a Twisted Ankle: There is mild stretching or tearing of ankle ligaments with some mild or zero joint instability. Mild pain, swelling and stiffness may be present. Patient may experience some difficulty in walking or running.
  2. Grade 2 Sprained Ankle or a Twisted Ankle: There is moderate tear of the ligaments with some joint instability. Patient experiences pain upon walking. Swelling and stiffness is also present along with mild bruising.
  3. Grade 3 Sprained Ankle or a Twisted Ankle: There is complete rupture or tear of the ligament fibers. Patient experiences acute pain and severe joint instability. Extensive swelling and bruising is present.[6]

How is Sprained Ankle or a Twisted Ankle Diagnosed?

Taking into consideration the fact that sprained ankle or a twisted ankle are common injuries, its diagnosis is fairly easy. A patient with a sprained ankle or a twisted ankle can be discerned through pain being located at the outside the ankle with swellings and tenderness. The use of X-ray will help to determine the fact that spraining and tearing of the ankle ligaments has happened and not the bone has been broken.

Other injuries are prone to occur and thus, it is unwise to regard any injury to be a sprained ankle or a twisted ankle. Tearing of the peroneal tendons as stipulated above is such an example. The anterior process of calcaneus and the fifth metatarsal are some of the bones that can be fractured. Warranty of an MRI (Magnetic Resonance Imaging) in severe cases has been recommended so as to rule out other ankle problems like damage of the cartilage. A sprain is not typically diagnosed with an MRI.

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Following are the sequence of tests suggested or conducted by your physician:

  • Physical exam, in which the doctor will check for points of tenderness and patient’s range of motion to determine if any specific position or movement causes pain.
  • X-ray to rule out any fractures.
  • Bone scan helps in detecting stress fractures.
  • Computerized tomography (CT) scans.
  • Magnetic resonance imaging (MRI) is helpful in visualizing any injuries to the soft tissue.[7]

How is Sprained Ankle or a Twisted Ankle Treated?

Treatment for Ankle Sprain or Twisted Ankle

The severity of the injury determines the treatment for sprained ankle or a twisted ankle. Many of the individuals are treating their less painful sprained ankle or a twisted ankle at home.

Medications for Sprained Ankle or a Twisted Ankle

Over-the-counter (OTC) relievers in most cases help in treating sprained ankle or a twisted ankle. Examples of such drugs are: ibuprofen (Advil, Motrin IB, others), acetaminophen (Tylenol others) or naproxen (Aleve, others) for pain management accruing from an ankle sprain.

Devices for Sprained Ankle or a Twisted Ankle

Crutches or Braces may be used in order to help with the pain caused by an ankle sprain when you are walking. There are movable devices that can be suggested by your doctor for you to use it such as a splint.

Physical Therapy (PT) for Sprained Ankle or a Twisted Ankle

The balance, strength, flexibility and the range of motion of your ankle can be restored through the help of your physical therapist as soon as the swelling subsides.

For the muscle to support the joint once again, stability and balance training is important in retaining the muscle to work in unison. Standing on one leg is an example of the challenging exercise that might be involved in the process.

Seek the doctor’s advice regarding when you are fit to resume the exercise that you were engaging in prior to getting your sprained ankle or a twisted ankle. In order to prevent re-injury, you might be needed to wrap your ankle or wear an ankle brace.

Surgery and other Procedures for Treating Sprained Ankle or a Twisted Ankle

An evaluation of a musculoskeletal specialist might be recommended by your doctor for sprained ankle or a twisted ankle. Proper healing of your joint might be achieved through the use of a walking boot, which immobilizes it. Surgery for repairing the damage of sprained ankle or a twisted ankle might be recommended by doctors for severe tear of the ligament, especially in elite athletes.

Home Treatment for Sprained Ankle or a Twisted Ankle

What to do for a Sprained Ankle or a Twisted Ankle at Home?

Many individuals are able to successfully treat their sprain at home.

  • R.I.C.E (Rest, Ice, Compression, and Elevation) therapy should be done.
  • Over-the-counter pain relievers such as ibuprofen, naproxen or acetaminophen help in relieving pain, swelling and inflammation.
  • The ankle can be taped for support and to reduce swelling.
  • Crutches for partial weight bearing can be used.
  • A cast or a brace can also be used.
  • After the swelling has subsided, gentle massage can be done to prevent the formation of adhesions.
  • After the swelling has subsided, then physical therapy exercises can be started to restore the ankle’s range of motion, flexibility, strength and balance.[8,9]

Ankle Sprain or Twisted Ankle: Treatment, Causes, Symptoms

How Long Does It Take To Heal a Sprained Ankle or a Twisted Ankle?

The general outcome for sprained ankle or a twisted ankle is usually good. Recovery for most of the ankle sprain patient has been absolute with majority of patients resuming activities, sports and normal live. Instability in walking has been occasioned by those who do not treat the ankle following a sprained ankle or a twisted ankle. Patients who are having ankle sprains repeatedly might result in having chronic instability.

Damage within the ankle can result owing to the repeated episodes of sprained ankle or a twisted ankle, which are dangerous. Repair should be recommended after this type of patient has been considered.

Is Rehabilitation Required for Sprained Ankle or a Twisted Ankle?

Every injury involving ligaments requires rehabilitation. Re-injuring of your sprained ankle or a twisted ankle is probable and it might fail to heal completely. Three phases are required for recovery of sprained ankle or a twisted ankle regardless of the situation if it is mild or severe.

  • Phase I. Rest, protect and reduce swelling of the sprained ankle or a twisted ankle.
  • Phase II. Restoring the flexibility of the ankle, the strength and the range of motion.
  • Phase III. This is the gradual return of activities that are straight-ahead while doing maintenance exercise. Later you can engage in elaborate sports like basketball, football or tennis.

Coordination, balance and flexibility of your ankle will require prescribed strengthening routine exercise from your doctor. This is once you are back on your feet. While you have supportive ankle brace or a taped ankle you can later jog, run or walk.

The rehabilitation program reduces the probability of hurting the same ankle; therefore, it is important to complete it. Arthritis, chronic pain, and instability of your ankle can result due to incomplete rehabilitation process of sprained ankle or a twisted ankle. Continued ankle pain is an indication of a ligament that did not heal in the proper manner or another injury also occurred.

Your soft tissues should be in good shape to ensure muscle flexibility, strength, and balance. The warning that the body gives should be adhered to and slowing down to avoid fatigue and pain in order to avoid any future ankle sprain.

What Exercises are Recommended for Sprained Ankle or a Twisted Ankle?

Stretching Exercises for Sprained Ankle or a Twisted Ankle

The below mentioned are a few stretching exercises for sprained ankle or a twisted ankle:

  • While you are seated, elevate you ankle as much as you are able to. You will feel a stretch in your calf, thus you do it slowly. Hold it and count it to 10. Repeat it 10 times.
  • Bring down your ankle and in from the starting position of seating. Hold the inverted position and count to 10. Repeat it 10 times.
  • Bring the ankle up and out again at the starting position. Hold the averted position and count to 10. Repeat it 10 times.
  • Count to 10 while you have held your toes down from the starting position. Repeat it 10 times.
  • When the pain has eased is the time you can do this exercise. Drop your ankles down a stair when you have stood at its edge while holding this position count to 10. Repeat it 10 times.
  • When the pain has subsided is when you can do this exercise. Point your toes to the wall while you have stood 12 inches from it. Squat and maintain the position and count to 10. Repeat it 10 times.

Strengthening Exercises for Sprained Ankle or a Twisted Ankle

The following are the strengthening exercises for sprained ankle or a twisted ankle:

  • Place your ankle in a fixed object for example a couch in ”down and in” position. Hold the position and count to 10. Repeat it 10 times.
  • The same object should be used while you have placed your ankle in apposition of ”up and out.” Hold the position and count it to 10. Repeat it 10 times.
  • Count to 10 while your ankle is pushed down against a fixed object. Do this 10 times.
  • Count to 10 while you have pushed up your ankle against a fixed object. Do this 10 times.
  • Use a resistance band wrapped around your forefoot while you have held it with your hands. Push gently the ankle down as far as your ankle allows you to and back to the starting point. Do this 10 times.
  • While you have tied a resistance and on a fixed object, the ends wrapped on your forefoot, pull the sprained ankle as far as it can while your foot is pointing down.
  • Cycle your ankle after returning to the same position 10 times.
  • Tie your ankle’s outer side with the band also on an object. Move your ankle in and down when you have started in relaxed position. Do it for 10 times after returning it to the relaxed position.
  • Hold your foot relaxed when you have tied the band’s end around an object. Elevate your foot and then rest to its original position of rest. Repeat it 10 times.

What is the Prognosis and Recovery Period for Sprained Ankle or a Twisted Ankle?

  1. Prognosis and Recovery Period for Grade 1 Sprained Ankle or a Twisted Ankle

    Prognosis is excellent following conservative treatment and controlling pain with analgesics for sprained ankle or a twisted ankle. The inflammation and pain responds well with non-steroidal analgesics. Recovery period for Grade 1 Ankle Sprain is between 2 to 4 weeks.

  2. Prognosis and Recovery Period for Grade 2 Sprained Ankle or a Twisted Ankle

    The prognosis is satisfactory and recovery may take between 4 to 10 weeks depending on the extent of ligamental tear. Partial ligamental tear often heals slowly depending on blood flow to the injured ligaments. Immobilization of ankle may cause muscle weakness and may need 4 to 6 weeks of physical therapy after wound is healed. Patient is able to resume near normal activities after 6 to 8 weeks following grade 2 sprained ankle or a twisted ankle.

  3. Prognosis and Recovery Period for Grade 3 Sprained Ankle or a Twisted Ankle

    The recovery time for Grade 3 sprained ankle or a twisted ankle may last over 8 to 10 weeks. The time required for healing of fractured ligament depends on type of ligamental injury. Complete ligamental tear with minimum or separations heal within 4 to 8 weeks and patient recovers within 8 to 12 weeks following 4 weeks of physical therapy. Complete separation of ligament take long time to heal. Healing period could be as long as 12 weeks or longer for Grade 3 sprained ankle or a twisted ankle. Prolonged immobilization of ankle causes muscle weakness and atrophy. Patient needs 4 to 6 weeks of physical therapy before resuming normal activities.

How to Prevent Sprained Ankle or a Twisted Ankle?

Sprained ankle or a twisted ankle can be prevented by taking the following steps:

  • Warming up prior to exercising or in sports participation.
  • Be cautious when running, working or walking on a rough surface.
  • Wear shoes that are fitting and suit for the particular activity.
  • Avoid high-heeled shoes.
  • Avoid participating on activities or sports for which conditions have not been clearly stipulated.
  • Maintain good muscle flexibility and strength.
  • Acquaint yourself with stability training like balance exercise.[10]

Frequently Asked Questions About Sprained Ankle or a Twisted Ankle

Is a High Ankle Sprain Different from a Regular Ankle Sprain?

Ligaments connecting fibula and tibia (this connection is also known as syndesmosis) might have a high ankle sprain. High ankle sprains are rare and less common ankle sprains than lateral ankle sprains, which in essence occur on any one (or both) of the ankle sides.

Is the Process of Repairing Sprained Ankle or a Twisted Ankle Acute?

Surgery is rarely ever needed to treat sprained ankle or a twisted ankle. (RICE) Rest, ice compression and elevation are the simple treatments that majority of the sprained ankles or a twisted ankles need. Physical therapy (PT) might follow and bracing for a short period of time.

Should a Recurrent Ankle Sprain be a Cause of Concern?

Yes. Problems are likely to develop when you have multiple sprained ankle or a twisted ankle. The cartilage found inside of you ankle joint can be damaged is such an example. If this is happening seek you doctor’s advice.

References:

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Team PainAssist
Team PainAssist
Written, Edited or Reviewed By: Team PainAssist, Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:January 5, 2022

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