An accurate diagnosis is always the best way to provide a healing plan of care. Examination by a sports medicine or orthopedic physician is advised. Acute ankle injuries can be either high or low. Low ankle sprains involve damage to any of the short ligaments that hold the bones of the ankle together and stabilize the ankle.
Low ankle sprains can occur on either side of the ankle. But most often, it’s the ligaments along the lateral (outside of the ankle) that are affected. This is because the mechanism of injury is usually plantar flexion (ankle and toes pointed downward) and inversion (toes pointed inward).
A high ankle sprain involves the ligaments above the ankle joint. This is called a syndesmosis injury. In an ankle syndesmosis injury, at least one of the ligaments connecting the bottom ends of the tibia and fibula bones (the lower leg bones) is sprained. Recovering from even mild injuries of this type takes at least twice as long as from a typical ankle sprain.
Low ankle sprains are most common. Swelling, pain, and difficulty walking are typical. An inability to put weight on the foot is suggestive of a severe ankle sprain or even bone fracture. X-rays are needed to rule out fracture.
Treatment for an acute low ankle sprain begins with nonsteroidal anti-inflammatory drugs (NSAIDs) to control inflammation. Rest, ice, compression, and elevation (RICE) are important at first.
A physical therapist guides the athlete through a rehab program of motion, proprioception (joint sense of position), and strengthening exercises. Movement and mobility while supporting the ankle with a brace (or some other type of removable, external support) are equally important. This is called functional therapy. Later in the rehab program, sport-specific exercises are added.