Sprained ankles are the most common musculoskeletal injury sustained by active individuals. Two types of sprains can occur: inversion and eversion. The most common ankle sprain is the inversion sprain (comprising 95% of ankle sprains), where the foot rolls inward spraining the ligaments on the outer part of the ankle. Upon exam, it is not unusual to have pain in front of the lateral maleolus (outside ankle bone) where the anterior talofibular ligament (ATF) sits. This if the first ligament injured when an ankle is rolled. In more moderate to severe ankle sprains the other 2 ligaments of the lateral ankle are injured; the calcaneal fibular ligament (CFL) and posteror talofibular ligament (PTF).
Ankle sprains also tend to swell quickly and a substantial amount. The target of initial treatment should be focused on swelling reduction, leading to the restoration of range of motion and function. The cornerstone treatment remains the pneumatic “R.I.C.E”.
REST – Immobilization, with ankle brace, aircast, or cast boot, depending on severity of injury
ICE – Ice pack to the side of the ankle for 20 minutes on, then 20 minutes off, for 24-48 hrs.
COMPRESSION – manual compression via ace wrap to reduce swelling
ELEVATION – elevation with 2 pillows when at rest, to prevent swelling the lower extremity