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Ankle sprain

    • Ankle sprains are one of the most common musculoskeletal injuries in people of all ages with at least >300,000 injuries per year in the United States (Nelson et al, 2007). The ankle joint is surrounded by ligaments that help stabilize the joint. A sprain occurs when these ligaments are stretched beyond the normal range of motion. Most sprains involve the ligaments on the outside of the ankle and are minor, but in more severe cases the ligaments can be torn leading to joint instability.

    • Symptoms for acute ankle sprains include swelling and bruising around the ankle, pain, tenderness, decreased range of motion and difficulty walking.

    • Chronic ankle sprain symptoms include repeated turning of the ankle, especially on uneven surfaces or when participating in sports, feelings of general ankle instability, persistent chronic discomfort and swelling and pain.

    • Diagnosis is based on detailed history, physical examination, and imaging. Certain physical tests may be utilized to reproduce symptoms and measure range of motion at time of exam. Magnetic resonance imaging (MRI) or musculoskeletal ultrasound may be used to identify and grade the tear.

    • In cases of chronic instability, an MRI may not recognize a partial tear of the ligament. Examining the ligament with ultrasound, and stressing the ligament may help identify partial tears or non-retracted complete tears.

    • Conservative Management
      • Initial treatment of ankle sprains consists of rest, ice, NSAIDs, bracing and physical therapy. Nonsteroidal anti-inflammatory drugs (NSAIDs) are used for pain relief and physical therapy may be utilized to improve strength and restore function.

    • Platelet Rich Plasma (PRP) Injections
      • PRP concentrates a patient’s blood to increase various growth factors. When injected into the injured ligament it stimulates the natural healing response for these chronic ligament tears.

    • Surgical Intervention
      • While a large number of ankle sprains can be handled conservatively, surgery may be necessary for more complex cases or chronic instability to reconstruct the injured ligament(s).

Nelson AJ, Collins CL, Yard EE, et al. Ankle injuries among United States high school sports athletes, 2005–2006. J Athl Train. 2007;42:381–387.