Clinical Reference Systems: Pediatric Advisor 10.0
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What is an ankle sprain?

An ankle sprain is an injury that causes a stretch or tear of one or more ligaments in the ankle joint. Ligaments are strong bands of tissue that connect bones at the joint.

Sprains may be graded I, II, or III depending on their severity:

• grade I sprain: pain with minimal damage to the ligaments
• grade II sprain: more ligament damage and mild looseness of the joint
• grade III sprain: complete tearing of the ligament and the joint is very loose or unstable.

Sometimes sprains are just classified as mild or severe, depending on the amount of ligament damage.

Most sprains occur on the outside part of the ankle, but they can occur on the inside as well.

How does it occur?

A sprain is caused by twisting your ankle. Your foot usually turns in or under but may turn to the outside.

What are the symptoms?

Symptoms of a sprained ankle include:

• mild aching to sudden pain
• swelling
• discoloration
• inability to move the ankle properly
• pain in the ankle even when you are not putting any weight on it.

How it is treated?

Treatment may include:

• Applying ice packs to your ankle for 20 to 30 minutes every 3 to 4 hours for the first 2 to 3 days or until the pain goes away. Thereafter, ice your ankle at least once a day until the other symptoms are gone.
• Elevating your ankle by placing a pillow underneath your foot for 1 day. Try to keep your ankle above the level of your heart.
• Wrapping an elastic bandage around your ankle to keep the swelling from getting worse. Keep the wrap on for 2 days.
• Wearing a lace-up brace or ankle stirrup (an Aircast or Gelcast).
• Using crutches until you can walk without pain.
• Taking anti-inflammatory pain medication such as ibuprofen.
• Doing ankle exercises to improve your ankle strength and range of motion. The exercises will help you return to your normal activity or sports.

Rarely, severe ankle sprains with complete tearing of the ligaments need surgery. After surgery your ankle will be in a cast for 4 to 8 weeks.

How long will the effects last?

The length of recovery depends on many factors:

• age
• health
• severity of injury and previous injuries to that joint.

How can I help prevent an ankle sprain?

To help prevent an ankle sprain, follow these guidelines:

• Wear proper, well-fitting shoes when you exercise.
• Stretch gently and adequately before and after athletic or recreational activities.
• Avoid sharp turns and quick changes in direction and movement.
• Consider taping the ankle or wearing a brace for strenuous sports, especially if you have a previous injury.