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Ankle Sprain: Signs, Symptoms, Treatment, Prevention

This is an excerpt from Sport First Aid-6th Edition by Robb S. Rehberg.

An ankle sprain is a stretch or tear of the ligaments holding the ankle bones together. It is caused by compression or torsion of the ankle joint. In an inversion sprain, the foot rolls in, damaging the outside ankle ligaments and sometimes the inside ligaments (figure 13.17). Inversion is the most common type of sprain, occurring in about 80 percent of all ankle sprains. In an eversion sprain, the foot rolls out, damaging the inside ankle ligaments and sometimes the outside ligaments.

Signs and Symptoms

Grade I

• Mild pain around the inside or outside ankle bones
• Mild pain when flexing the foot up or pointing it down
• Slight point tenderness just below the outside or inside ankle bones (tibia and fibula)

Grades II and III

• Moderate to severe pain around the inside or outside ankle bones
• Moderate to severe pain when flexing the foot up or pointing it down
• Moderate to severe point tenderness just below the outside or inside ankle bones (tibia and fibula)
• Feeling of looseness or instability
• Hearing or feeling a pop
• Swelling
• Inability to bear weight, or limping when walking

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FIRST AID

Grade I

1. Rest the athlete from painful activities.
2. Apply ice to the injury for 15 minutes, then apply a compression wrap.
3. Refer the athlete to the appropriate health care provider if symptoms and signs worsen (or occur more often, especially with daily activities such as walking) or do not subside within a few days.

Grades II and III

1. Rest the athlete from all activities that require use of the leg.
2. Prevent the athlete from walking on the injured leg.
3. Monitor the athlete, treat them for shock if needed, and send for emergency medical assistance if shock occurs.
4. Send for emergency medical assistance if you notice signs of fracture (obvious deformity or pain at the site of the injury when the tibia and fibula are gently squeezed above or below the injury, or pain along the midline of the lower third of the tibia or fibula); symptoms and signs of nerve compression (tingling and numbness); or symptoms and signs of disrupted blood supply (bluish toes and toenails).
5. Apply ice to the injury for 15 minutes, and send the athlete to the appropriate health care provider (if emergency medical assistance is not sent for).

Playing Status

• For a Grade I ankle sprain, the athlete can return to activity if signs and symptoms subside; the ankle is free of pain; and they have full ankle range of motion, lower leg strength, and calf and Achilles tendon flexibility. If the athlete is sent to a health care provider, they cannot return to activity until examined and released by the health care provider. When returning to activity, the athlete should wear a protective brace.
• For a Grade II or Grade III ankle sprain, the athlete cannot return to activity until examined and released by a health care provider; the ankle is free of pain; and they have full ankle range of motion, lower leg strength, and calf and Achilles tendon flexibility. When returning to activity, the athlete should wear a protective brace.

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PREVENTION

• Preseason exercises to strengthen the lower leg, calf and Achilles tendon stretching, and balance training

More Excerpts From Sport First Aid-6th Edition

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