Rob Gronkowski of the New England Patriots has recently highlighted the impact an ankle sprain can have on functional ability.
When we think of ankle sprains, most of us think of an injury that occurs with a roll or twist of the outside of the ankle, but there are many different kinds of sprains and they certainly can't be lumped into one category.
Lateral ankle sprains are the most common injury in all of sports, and are examined in the emergency room more than 500,000 times per year. They are typically classified into one of three grades that indicate the level of damage done to the supporting ligaments.
Grade I sprains involve minor stretching, but not tearing, of the ligaments. Mild swelling and minor pain should be expected, but should pass within a couple days to a week at which time you'll return to normal.
Grade II sprains are characterized by a much wider scope of damage and much broader scope of symptoms. Bruising, swelling and pain can all be severe and will certainly be present. Significant grade II sprains often require crutches and take several weeks to heal — and may need therapy if symptoms persist.
Grade III sprains involve a complete rupture of the ligaments holding your ankle together. Swelling will be immediate and intense, and dark purple bruising will show up within a few days. Grade III sprains almost always require some sort of continued physical therapy care to ensure a good, long-term recovery.
A medial ankle sprain is a sprain of the ligaments on the inside of the ankle. The ligaments on the inside are tough and thick, making them difficult to damage. In fact, they're so strong that stretching them may take a small piece of bone off the ankle if the force is great enough. Medial ankle sprains require immobilization for at least a couple weeks and depending on the severity, may need as much as two months before they're fully recovered.
High ankle sprains are much more serious than the previously mentioned types and are slow to resolve with conservative management. The ligament that holds the two bones of the lower leg together can be disrupted and torn during high-energy trauma. If torn, the bones of the lower leg will lack stability and slide apart during weight bearing.
This lack of stability can cause an enormous amount of nerve and tendon damage, making a high-ankle sprain a tremendous threat to your function. Typically, rest and immobilization are needed to help the ligament heal, but surgical fixation is required in a high number of cases. Pinning the bones of the lower leg together to help keep them in place when you weight-bear may be the best option to get you back on your feet.
Most ankle sprains are benign in nature, leaving no lasting deficits and requiring no formal treatment.
But serious injuries occur and do require help — so if you have any signs of a higher-grade sprain, get checked out as soon as you can.
Joe DiVincenzo is a physical therapist and clinical specialist in manual therapy. He writes "On the Mend" weekly. Questions may be submitted to Joe by e-mail joedivincenzo@comcast.net.
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