Ankle sprains are among the most common injuries encountered by professional and recreational athletes alike and frequently contribute to missed playing time.

An ankle sprain is a tear in the ligaments that support either the inner or outer aspect of the ankle joint.  This usually occurs when the athlete rolls the ankle inward  after stepping in a hole or onto another players foot.  As the foot rolls in (inverts) the ligaments connecting the outer bone of the ankle to the foot are stretched and torn to various degrees.  A grade I injury is mild and will limit play for less than a week.  Grade II injuries are moderate and last 1-3 weeks, while a grade III sprain is severe and may limit the player for 6 weeks or more.  Often bruising of the bones within the ankle can occur simultaneously.

Signs of an ankle sprain include pain, swelling, bruising, inability to bear weight, and a feeling of instability.  Initial management should be with the RICE protocol,  which stands for rest, ice, compression, and elevation.  For minor injuries x-rays and evaluation by a physician may not be necessary, but for any significant problems consult your doctor.

Preventing sprains and returning to sports quickly are related issues.  The muscles that control movements around your foot and ankle need to be kept strong to prevent injuries and to rehabilitate an injured ankle.  Use of high top sneakers, ankle taping, and brace wear may be indicated in certain individuals.

Occasionally an athlete will develop chronic ankle instability, where long after healing of a sprain (or multiple sprains) the ankle still feels like it gives way or is loose.  This is often caused by incomplete rehab of an injury or may be a sign of chronic stretching of the ligaments in the ankle.  In some cases the chronically stretched ligament has to be surgically shortened or substituted for.

Dr. Baltz is a fellowship trained Sports Medicine Orthopedist, former assistant team physician to the Boston Celtics and team physician to Massachusetts Maritime Academy.