Sprained ankle 

What is a sprained ankle?

A sprained ankle is an injury of the ankle ligaments caused by twisting or being stretched beyond their limit of movement.

There are three types of sprained ankle, classified by severity:
1. Grade I sprains are the least severe. Ankle ligaments are not torn. Swelling and pain are mild. There may be effusion (the collection of fluid in the joint). In this case, it is possible to resume physical activity after a short period with a functional bandage.
2. In grade II sprains, ligaments are partially torn. Pain and swelling are greater. Fewer foot movements can be made.
3. In grade III sprains, ligaments are completely torn. Pain is intense. Foot movement is very restricted. The injury is accompanied by much greater effusion, and hence surgery is sometimes required.


Generally, the majority of sprained ankles are mild injuries, however, some cases can be more serious, requiring longer recoveries and sometimes surgery.

Symptoms of a sprained ankle

The most relevant signs and symptoms of this injury are:
     • Moderate pain
     • Weakness
     • Inflammation
     • Haematoma
     • Joint rigidity
     • Difficulty walking

Medical tests for ankle sprains

The diagnosis is essentially clinical and is based on the review of the patient’s history and a physical examination, via evaluating manoeuvres, such as the anterior drawer test, the forced inversion test, the forced external rotation test and the squeeze test. An X-ray may be very helpful in ruling out associated bone fractures or complete ligament tears.

What are the causes of ankle sprains?

A sprain may be caused by a direct impact on the ankle or following a fall or tripping over.

Can a sprained ankle be prevented?

It is impossible to prevent a sprained ankle, but we can adopt several measures to reduce the probability of ankle sprains:

• Always perform warm-up exercises and the stretches recommended for ankles before doing sports or any other physical activity.
• Take extra care when walking or running over uneven surfaces.
• Avoid carrying out physical activities when tired, as this increases the probability of injury.
• Using compression bandages, ankle supports or high-top footwear can help if you have a propensity for ankle sprains.
• Wear high-quality footwear, of the right size and laced-up correctly. In women, one of the primary causes of ankle sprains is wearing high-heeled shoes.

How are sprained ankles treated?

Generally, surgery is not necessary in the treatment of ankle injuries, given that the majority of ankle sprains are mild injuries that heal with minimal treatment. Some cases may be more serious, but will never require surgery.

Generally, treatment for ankle sprains consists of:

• Resting the ankle (at least the first two days).
• Cooling down the affected area for 20 minutes every 2 or 3 hours with ice.
• Compressing with an ankle brace and elevating the leg so that the toes are above the level of the nose.
• Physiotherapy may also be important for recovery.

Medications for sprained ankles:

Anti-inflammatory medications provide pain relief and reduce swelling.

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