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Published on September 29, 2020

Sprained an ankle? Don’t just walk it off

Ankle Sprain

Whether they’re caused by jogging on an uneven surface or walking on stiletto heels, ankle sprains are one of the most common musculoskeletal injuries. An estimated two million people suffer this injury each year in the U.S.

The big mistake that most of them make is thinking it’s no big deal.

Most people do not seek medical treatment for an ankle sprain – but 75 percent of those who sustain an acute ankle sprain suffer long-term effects, including chronic ankle instability and a high rate of re-injury, according to studies published in a recent issue of the Journal of Athletic Training.

According to the Journal, ankle sprains are the most common injury experienced by athletes and other people who are physically active. 

“Ankle sprains can happen to anyone,” said Catherine Hoell, PT, DPT, OCS, an orthopedic physical therapist with the Cape Cod Hospital Rehabilitation Center. “We see young kids spraining ankles in sports injuries, and we see older folks spraining their ankles from poor balance. The reasons may vary, but we see it in every age group.”

It’s because they are so common that many people feel they can ignore them, she said.

3 Grades of Severity

Ankle sprains fall into three grades

  • Grade 1: A stretching of the ankle ligament, leading to tenderness, swelling and stiffness. You can walk with a small amount of pain.
  • Grade 2: An incomplete tear of the ligament, which causes moderate pain, swelling and bruising. Walking is painful.
  • Grade 3: A complete tear of the ankle ligament, leading to severe pain, swelling and bruising. Because the ankle is unstable, walking is difficult or impossible.

“If it’s not too bad, everybody knows to do the RICE (Rest, Ice, Compression, Elevation) treatment,” she said. “But when you get a more serious ankle sprain, you need to see an orthopedist and then get physical therapy.”

Recovery time varies depending on the patient’s age, activity level and degree of injury. Recovering from a Grade 2 sprain might take three to six weeks, she said, and up to 12 weeks for a Grade 3 sprain.

Stretch it Out

Maintaining flexibility is an important part of injury prevention, Hoell said.

“If you don’t warm up before your sports or before your activity with some stretching or dynamic movement, you are more at risk,” she said.

“The risk factors go up if you have a previous history of an ankle sprain, especially if you don’t have treatment to regain a full range of motion. If you don’t have the right range of motion, that can make your ankle more susceptible because it’s not able to make modifications on an uneven surface.”

Other risk factors include limited ankle dorsiflexion (the ability to move your foot toward your shin) and having high arches.

In addition to flexibility, overall leg strength can help prevent ankle injuries.

“If the knees and hip are weak, that can make you more at risk for an ankle sprain,” she said.

“A good sense of balance helps, too. You can strengthen that by balancing on one leg, eyes open and then eyes closed. Doing that for 30 seconds is a benchmark for normal balance on one leg.”

If you want to work on injury prevention, you can meet with a physical therapist.

“We do physical wellness checks, and we can assess your mobility, strength, stability, balance and coordination,” she said.