Ankle Sprains, Part 1

Ankle sprains are one of the most common injuries in American high school athletes, occurring over 300,000 times per year. Ankle injuries rates are highest in sports that combine jumping near others and rapid direction changes while running. The winter sports of basketball and wrestling certainly place strong and dynamic stress on the ankles, making this a good time to consider how to handle ankle sprains if they occur to you or someone on your team. 

Half the time, symptoms from ankle sprains resolve in one week, but 30% of people will still have symptoms one year later. Proper early injury care is considered essential in recovery, especially for sprains that result in swelling and bruising. At i’move we highly recommend that athletes with ankle sprains are evaluated by their school’s athletic trainer as soon as possible to determine the extent of the injury.

Once a sprain has occurred, the acronym to remember is P.R.I.C.E (Protect, Rest, Ice, Compression and Elevation). Protection can take many forms including taping and ankle braces. Rest is important depending on the severity of the injury as it takes time for healing to occur. Ice, compression and elevation are important tools to decrease the swelling since uncontrolled swelling will lead to stiffness and loss of movement. Inappropriate use of ice and compression can cause further injury however. Ice should be applied a maximum of 20 minutes every hour. Light compression is usually sufficient as too tight of compression can restrict blood flow to the ankle. Compression is most important when the ankle is going to be down for several hours, for example, while sitting in class all day.

Ankle sprain severity is graded on a three point scale, based on the estimated severity of the injury. Grade One injuries are painful right at the injury site, but usually don’t show swelling or bruising. You can “walk off” a grade I injury, but it will feel quite stiff first thing the next several mornings. P.R.I.C.E. care for 2-3 days followed by stretching and careful return to sport is usually effective. It is important the athlete feels they have regained their flexibility, balance and strength prior to return to sport. Grade Two injuries are more painful and damage more of the ligaments. These injuries will be much harder to “walk off” and normally produce swelling and bruising. Grade Two injuries should be evaluated by a licensed health care professional (athletic trainer, physical therapist or doctor). The recovery time frame will be longer with a Grade Two injury. Grade Three injuries are the most severe and will require proper medical attention.

Risk of ankle sprains is difficult to determine, however people with previous leg injuries, females, and those with leg posture problems (“knock knees”, very high or very low foot arches) or poor balance tend to show higher ankle injury rates. Prevention is always the best medicine, and spending time now working to improve balance, flexibility, and strength will pay benefits later, keeping you in the game.

Ankle Sprains Part 1 by Jeff Clark, PT, OCS, FAAOMPT