The ankle is the joint that begins at the end of the tibia and fibula, your leg bones. The tibia joins up with the talus, a bone just below that has a dome like structure. When you hear the term sprain we are specifically talking about a ligament injury. Ligaments are tough connective tissue that attaches one bone to another. Their function is to provide stability when a joint moves.
When a ligament is injured it usually stretches and is called a sprain. However, ligaments can also partially and fully tear which can make a joint unstable. There are three main ligaments on the outside of the ankle and one on the inside. The most common ligament that is injured is on the outside and when it is injured it can cause bleeding which is seen as bruising on the skin surface.
Most ligament injuries will heal with conservative treatment: RICE (rest, ice, compression and elevation). It is important to always elevate the extremity above the heart by laying down with the ankle propped up on two or three pillows. It may be necessary to use crutches for a few days and an ankle brace to allow the sprain to heal.
If the ankle does not appear to be getting better and the pain persists then it is necessary to seek the help of an orthopedic surgeon. Sometimes what we think are simple ankle sprains are fractures that may need surgery. Other times we will place the patient in an Ankle boot that has air bladders inside. This allows the patient to walk on the sprained ankle while unloading the ankle joint.
Depending on the extent of the ankle sprain it can take anywhere from days to months to heal. If your ankle sprain is severe enough and you see an orthopedic surgeon, you may be sent for a course of physical therapy. Before you can get back to sports or physical activities you should have good range of motion that is pain free and weight bear without any pain.
I am often asked whether or not an ankle brace is useful. Many professional athletes such as tennis players and soccer players wear a brace when playing to prevent sprains. If you are prone to ankle sprains an ankle brace would be good prevention. Also strengthening your ankle with simple ankle exercises will lower your risk.