Most people describe it as a twisted ankle, but, in fact, it is about an ankle sprain, as one or more ligaments that stabilize the ankle are “involved”. This is one of the most common injuries in individuals who practice sports; most epidemiological studies have focused on those individuals.
The sprain occurs when the foot “twists” and the ligaments, the strong fibrous tissues that bind the bones together and stabilise the joint, stretch beyond their limits, and tear apart. Depending on the degree of disruption, the injury is classified from mild (healing at home with rest and ice therapy), to too severe, when the tear is complete. Most sprains occur in the lateral collateral ligaments (LCLs).
Without the appropriate treatment, a severe sprain may weaken the ankle, making it vulnerable to a new injury, while repetitive sprain injuries in the ankle may lead to long-term problems, such as arthritis and joint instability, which may cause bone and cartilage damages.

A study published in The American Journal of Sports Medicine in 2010, with regard to the US, concluded that a higher risk of ankle sprain is observed at the 10-19 age group. Boys and men aged 15 to 24 show higher rates than girls and females at the respective ages. Contrariwise, the risk of sprains is much higher for women, when they are aged over 30.
The most common injury mechanisms are walking or exercising on an uneven surface, falling on the ground, traffic accidents, sports requiring a sudden stop, sports such as tennis, mountain running or football, or when someone steps on the foot of a runner.

This specific injury can be quite painful, especially when a complete tear or dislocation of the ankle occurs. Common symptoms include swelling, bruising, pain upon palpation, and restriction of the range of motion. As signs in severe cases are the same as those of the fracture, sprains require an immediate assessment. The orthopaedist shall perform a clinical examination and obtain a detailed history. An X-ray shall exclude the indication of a fracture, and if a serious injury is suspected, an MRI may be required to visualize the damage to the ligaments, cartilage or a bone.

Treatment depends on the extent of the damage, but a three-phase programme - according to the American Academy of Orthopedic Surgeons - can be applied in all cases. Firstly, rest is recommended, in order for the swelling to subside, and for the protection of the ankle. Thence, the range of motion, strength and flexibility are restored, and the third phase includes maintenance exercises and a gradual return to activities which do not require any ankle rotation. Depending on the sprain, the programme may require two weeks, or from 6 to 12 weeks for more severe damages. An important part of the treatment consists in the rehabilitation exercises to prevent stiffness, strengthen the ankle, and for long-term ankle problems to be avoided.
Surgical treatment for sprains is uncommon, but it is a solution for patients who do not respond to conservative treatment, and those who present a persistent instability, even after months have gone by. The surgeon shall remove whatever blocks the joint (bone, cartilage or ligament fragments) arthroscopically, namely through very small incisions and special surgical instruments. The torn ligament shall either be repaired or replaced by a graft originating from a tissue or a tendon, obtainable by the patient themselves. Postoperatively, a splint is placed and a recovery period follows, which may last for weeks or months, so that the joint regains its strength and range of motion.

Do you need a
Second Opinion

Are you sure about the diagnosis and the treatment that has been suggested to you? Fill in the form below to request a second opinion from Dr. Konstantinos Indzoglou.

    Make an

    And we will contact you!

      Add testimonial description here. Edit and place your own text.

      John Doe


      Add testimonial description here. Edit and place your own text.

      Jane Doe


      need help?

      Lorem ipsum dolor sit amet, consectetur adi pisicing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua.