An ankle sprain is a common injury and usually results when the ankle is twisted, or inverted. The term sprain signifies injury to the soft tissues, usually the ligaments, of the ankle. On the lateral side of the ankle, there are three ligaments that make up the lateral ligament complex. These include the anterior talofibular ligament (ATF), the calcaneo–fibular ligament (CF) and the posterior talofibular ligament (PTF). The very common inversion injury to the ankle usually injures the anterior talofibular ligament and the calcaneo–fibular ligament. The ATF ligament keeps the ankle from sliding forward and the CF ligament keeps the ankle from rolling over on its side.

Causes of Ankle Sprain
A ligament is made up of multiple strands of tissue–similar to a nylon rope. A sprain results in tearing of the ligaments. The tear can be a complete tear of all the strands of the ligament or a partial tear, where a portion of the strands of the ligament are torn. The ligament is weakened by the injury which depends on the degree of the tear. The lateral ligaments are by far the most commonly injured ligaments in a typical inversion injury of the ankle. An inversion injury simply means that the ankle tilts over to the inside (towards the other foot), and the pressure of all your body weight is forced onto the outside edge of the foot. This causes the ligaments on the outside of the ankle to stretch and possibly tear.

Symptoms of Ankle Sprain
Initially the ankle is swollen, becomes painful, and may turn eccyhmotic (bruised). The bruising, and the initial swelling, is due to ruptured blood vessels from the tearing of the soft tissues. Most of the initial swelling is actually bleeding into the surrounding tissues. This initial swelling due to bleeding then increases due to edema fluid leaking into the tissues as well over the next 24 hours.

Diagnosis of Ankle Sprain
The diagnosis of an ankle sprain is usually made by examination of the ankle and x–rays to make sure that there is no fracture of the ankle. If there is a complete rupture of the ligaments suspected, your doctor may order stress x–rays as well. These x–rays are taken while someone twists or stresses the ligaments.

Treatment of Ankle Sprain

• Elevation will help control the swelling.
• Gentle compression and ice will control swelling.
• Mild pain relievers will help with the pain.
• Crutches will prevent weight bearing.
• Healing of the ligaments usually takes about six weeks. The swelling may be present for several months. A physical therapist may be suggested to help you regain full function of your injured ankle.

Treatment may vary depending on how bad your ankle sprain is. In each case, the first line of treatment is to calm the inflammation and halt the swelling. The RICE (Rest, Ice, Compression, Elevation) principle can help address each of these needs.

• Rest:
  A brace or splint will keep the ankle in a safe position, helping you avoid more strain to the sore area. In severe cases, you may require a pair of crutches to limit weight through the foot.
• Ice:
  Cold therapy, in the form of an ice pack, can aid in slowing the inflammatory process and in limiting pain.
• Compression:
  An elastic wrap can compress the sore area, keeping the swelling to a minimum.
• Elevation:
  Keeping the ankle elevated above the level of your heart will help drain the extra fluid (edema) back into the blood system and reduce swelling.
• Range of motion exercises:
  As healing gets underway, it is important to begin a series of movement exercises for the range of motion (ROM). At first, you’ll work on simply bending and straightening the ankle. These exercises will keep the ankle from becoming stiff.
• Strength progression:
  Next, you’ll begin strengthening the muscles around the ankle. Isometrics may be chosen in the early stages of rehabilitation. These are strengthening exercises in which the muscles are working but the joint stays still. Isometrics allow you to exercise with the ankle at different angles, helping you stay away from painful positions of the ankle. These exercises provide the benefit of reducing overall pain and swelling.
• Balance exercises:
  Balance exercises are especially important following an ankle ligament injury. Remember, healthy ligaments send information to the brain about the position of a joint. Once a ligament has been injured, these nerves are unable to receive and send the needed information to the brain. Balance exercises help retrain the new nerves and help you regain your proprioceptive sense around the joint.