Ankle sprains are one of the most common sports injuries and can happen in just about any sport--from little league to the pros. It has been reported that nearly 25,000 such injuries occur each day. The ankle joint is maintained by ligaments, which are stretchy structures that support movement in and around the actual bony joint. During a sprain, the ligaments are stretched beyond their normal capacity, creating pain and inflammation that correlates to the amount of the over-stretch. When is a sprain just a sprain and when is it something more serious? And how are these injuries treated?
Depending on the specific mechanism and force involved in the injury, ligaments can get stretched to a point where they sustain only mild tears of some of the collagen fibers (the tissue that makes up the ligament). This is called a grade I sprain and treatment is mostly supportive, as this type of an injury does not require any specific splinting. Conservative treatment may involve rest, ice, elevation and perhaps an elastic bandage. The athlete or unlucky non-athlete should be back to regular activities within a few days without too much discomfort.
A grade II sprain is a bit more involved and usually presents with more swelling and discomfort to the ankle joint. This is due to a more significant amount of tearing of these collagen fibers, to the point where the involved ligament is partially torn. Understandably, treatment is more intricate and usually requires some splinting, such as an air-cast; some physical therapy for stretching and strengthening may be necessary. Weight bearing is usually more difficult but tolerable within a few days after the injury is allowed to heal. Crutches may be helpful until that happens.
Finally, a grade III sprain means a complete rupture of the involved ligament. This happens because the injured ligament gets pulled so far past its stretchy limit that it tears completely. If this occurs, the ankle joint should be immobilized as it has been otherwise destabilized. Crutches are helpful here as well. Physical therapy is recommended and is usually more involved than with a grade II sprain. Unfortunately, sometimes surgery becomes necessary as well.
An urgent care center is helpful when such an acute injury occurs, since a medical provider is able to accommodate a patient quickly after the injury, examine the affected ankle, order an X-ray on-site if necessary (they help to exclude any bone problems like fractures and dislocations), and stabilize the ankle joint as indicated by the level of the sprain. Physical therapy can also be ordered and a recommendation can be made for follow-up with the appropriate provider. If you or a family member sprain an ankle this spring, don’t hesitate to head to your nearest CareWell Urgent Care center!
Dr. Olivier M. Gherardi, CareWell Urgent Care