The ankle affected by sprain may show the following signs and symptoms:

• Development of swelling accompanied by pain 
• Bruising
• Bone tenderness and stiffness
• Inability or difficulty to bear weight depending on extent of injury
• Discoloration of skin
• Difficulty and pain while walking

• Pain

  Pain-free weight-bearing capacity increased over the 2-week course of rehabilitation and the subject was able to return to playing soccer without pain. [ncbi.nlm.nih.gov]

• Swelling

  INTERVENTION: The experimental group received Kinesio Taping application for 3 days, which was designed to treat swelling. The control group received an inert Kinesio Taping application. [ncbi.nlm.nih.gov]

  This causes the ligaments of the ankle to tear, leading to swelling and pain. [symptoma.com]

  Symptoms and Signs Ankle sprains cause pain, swelling, and sometimes muscle spasms. [msdmanuals.com]

• Weakness

  The ankle range of motion being relatively small, the use of preloading allows to measure maximal strength throughout the whole amplitude and therefore to better characterize ankle muscles weaknesses. [ncbi.nlm.nih.gov]

  Symptoms include burning pain, shooting pain, numbness, and muscle weakness, all of which are usually exacerbated by walking. Muscle weakness often causes re-injury due to reduced coordination. [livestrong.com]

  Sometimes ankle sprains occur because a person is born with weak ankles. Previous ankle or foot injuries can also weaken the ankle and lead to sprains. [foothealthfacts.org]

  During an ankle sprain, muscles and tendons can be stretched as well, thus leading to weakness. There are three different grades of an ankle sprain, depending on the severity of the injury. [sportsandspinerehab.net]

  Some people with repeated or severe sprains can develop long-term joint pain and weakness. Treating a sprained ankle can help prevent ongoing ankle problems. [airrosti.com]

• Falling

  The median age was 32 (range 21 to 45) years, and the injury occurred as a result of a motor vehicle accident in 6 (66.67%) patients, and as a result of a fall from a height in 3 (33.33%) patients. [ncbi.nlm.nih.gov]

  Most ankle sprains happen when the foot turns inward as a person runs, turns, falls, or lands on the ankle after a jump. This common type of sprain is called an inversion injury. [massgeneral.org]

  This puts you at risk of twisting your ankle or even falling. Placing unusual stress to the ligament. This could be from walking or running on an uneven surface, jamming your foot, or twisting your ankle in an odd way. [upmc.com]

  Comprehensive Orthopaedic Treatment Foot and ankle sprains, strains, and fractures are common injuries that can result from a sports injury, fall, or accident. Regardless of the cause, these conditions can make it difficult or painful to walk. [utswmedicine.org]

  An ankle sprain can occur from falling, or sudden force on the ankle which twists the joint beyond its normal range, resulting in damage to the ligament. [orthopaedicsurgeryspecialists.com]

• Inflammation

  Prolonged pain without inflammation occurs primarily with nerve injury. Chronic pain frequently disrupts normal walking, which then can affect joints of the hips, lower back and knees. [livestrong.com]

  Because most of the pain is caused by inflammation, you should try to reduce inflammation and keep it from happening. Remember R.I.C.E.: Rest prevents further injury and avoids stress on already inflamed tissue. [webmd.com]

  White blood cells responsible for inflammation migrate to the area, and blood flow increases. The following are signs and symptoms of inflammation: Swelling: Due to increased fluid in the tissue, this is sometimes severe. [emedicinehealth.com]

  Antiinflammatory medications can be given to reduce local inflammation. Severe injuries are placed in immobilization casts. Surgery may be needed for complete tears. [medicinenet.com]

  Rest, protection (brace, wrap, splint, and/or crutches) Control inflammation (ice, compression, elevation) Early weight bearing as tolerated II Phase II treatment begins once pain and swelling have subsided to the point where the athlete can comfortably [healthychildren.org]

• Heart Disease

  Talk with your provider before using these medicines if you have heart disease, high blood pressure, kidney disease, liver disease, or have had stomach ulcers or internal bleeding in the past. [medlineplus.gov]

• Skin Disease

  National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/Health_Info/Sprains_Strains/default.asp. Published July 2012. [cancercarewny.com]

  External resources National Institute of Arthritis and Musculoskeletal and Skin Diseases Information Clearinghouse National Insitutes of Health 1 AMS Circle Bethesda, MD 20892-3675 Phone: 301-495-4484 Toll-Free: 1-877-226-4267 Fax: 301-718-6366 TTY: 301 [drugs.com]

  National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/Health%5FInfo/Sprains%5FStrains/default.asp. Updated January 30, 2015. [winchesterhospital.org]

• Skin Discoloration

  Moderate bruising or skin discoloration may be present, and the patient may have some trouble walking or standing. [sports-health.com]

  If you heard a popping sound when you sprained your ankle, if the ankle looks abnormally bent, and/or if the swelling is severe and the skin discolored, you should suspect a severe sprain or even a fracture and see a doctor or go the emergency room as [healthcentral.com]

  You may have a sprained ankle if you notice the following symptoms in the ankle: swelling tenderness bruising pain inability to put weight on the affected ankle skin discoloration stiffness The ankle can sustain many different types of injuries. [healthline.com]

• Ulcer

  Talk with your provider before using these medicines if you have heart disease, high blood pressure, kidney disease, liver disease, or have had stomach ulcers or internal bleeding in the past. [medlineplus.gov]

  People with a history of stomach irritation or ulcers should not take anti-inflammatory medication without physician advice or supervision. [thesteadmanclinic.com]

• Fracture

  The purpose of this study is to determine the incidence of associated occult avulsion fracture in children with lateral ankle sprain and the efficacy of identifying fractures using anterior talofibular ligament view. [ncbi.nlm.nih.gov]

  Ankle sprains should be differentiated from avulsion fractures of the base of the 5th metatarsal, Achilles tendon injuries, and talar dome fractures, which may cause similar symptoms. [msdmanuals.com]

• Ankle Pain

  Significant functional disability followed a seemingly innocuous ligamentous sprain of the ankle. Persistent ankle pain following minimal trauma should alert the surgeon to the anomalous peroneus brevis symptom complex. [ncbi.nlm.nih.gov]

  However, you should call your doctor if you have any of the following: Inability to move the ankle without significant pain Inability to put any weight on that foot Pain over a bony part of your foot or ankle Pain that interferes significantly with walking [uvahealth.com]

• Short Legs

  If there is tenderness directly over the bone where the growth plate is located, then the injury will be treated as a fracture which usually involves a short leg cast or air cast for 4-6 weeks. [massgeneral.org]

  Immobilization: A splint, short leg cast, or boot may be used to immobilize the ankle and allow healing to take place with a grade 2 or 3 sprain. [orthopaedicsurgeryspecialists.com]

  A short leg cast may be advised in severe cases, but this is rare. Over-the-counter medications may be advised to reduce pain. Physical Therapy A physical therapist will assess the ankle. [winchesterhospital.org]

• Foot Pain

  However, you should call your doctor if you have any of the following: Inability to move the ankle without significant pain Inability to put any weight on that foot Pain over a bony part of your foot or ankle Pain that interferes significantly with walking [uvahealth.com]

  Call PhysioWorks Book Online Related Injuries General Information Heel Pain Ankle Pain Foot Pain Heel Pain Heel Spur Traumatic Ankle Ligament Injuries Sprained Ankle High Ankle Sprain Tendinopathies/ Fasciopathies Achilles Tendon Rupture Achilles Tendonitis [physioworks.com.au]

• Muscle Strain

  A strain, often confused with a sprain, is a stretching or overuse of muscles and tendons. A strain is often described as a "tight muscle." [thesteadmanclinic.com]

• Irritability

  People with a history of stomach irritation or ulcers should not take anti-inflammatory medication without physician advice or supervision. [thesteadmanclinic.com]

• Seizure

  Prolonged use of certain medications, such as those used to treat lupus, asthma, thyroid deficiencies, and seizures. Low calcium intake. Lack of physical activity. Smoking. Excessive alcohol intake. [youtube.com]

• Paresthesia

  which is composed of the anterior talofibular, calcaneofibular, and posterior talofibular ligaments. [1, 2, 3, 4] Signs and symptoms Signs and symptoms of an ankle sprain include the following: Pain/tenderness Swelling and/or bruising Cold foot or paresthesia [emedicine.medscape.com]

A thorough physical examination of the affected ankle will be carried out. Imaging studies such as X-rays will be required to rule out fractures. In addition to plain radiograph imaging, stress–view radiograph tests may also be performed, to get better insights about the ankle sprain [7].

MRI is seldom indicated in such cases. However, when certain unusual characteristics features are present, such as acute pain, ecchymosis or excessive swelling, then MRI can be performed. In such situations, MRI studies may reveal osteochondral lesions, which are usually not revealed on plain radiographs [8]. CT scan is indicated in conditions of complex injuries and to determine osteochondritis dissecans.

Treatment regime for ankle sprain is designed with the major goal of pain reduction, and restoration of lost motion. While mild cases of ankle sprain can be treated at home, moderate to severe cases may require more rigorous intervention.

According to the National Institute of Health, application of ice on the affected area for at least 10 to 15 minutes is utmost necessary for reducing the swelling. This should be repeated every hour. Pain relieving medications are also administered. Thereafter, the affected ankle is supported with braces so that there is limited motion.

Individuals are also not allowed to put weight on the ankle, and rest as much as possible. In many cases, the affected area is covered with ACE bandage to restrict motion, and reduce the pain [9]. Surgery is indicated only in cases when there is severe damage to the ligament.

Ankle sprains which are adequately treated have an excellent prognosis. Time taken for complete recovery would majorly depend on the extent of severity of the condition. In about 36 to 85% cases of acute ankle sprain, affected individuals recovered between 2 weeks to 36 months with proper treatment [6].

Individuals, who participate in competitive sports, are at an increased risk of developing recurrent sprains. However, even in such cases, when the treatment is initiated with appropriate rehabilitation program, then the prognosis of the condition is extremely favorable.

Ankle sprain occurs when the ankle undergoes an inverted twist due to sudden movement, which causes ligament tear. This may further lead to swelling and pain in the ankle, and it would get difficult for the individual to bear weight. Individuals can develop ankle sprain at any age. However, there are certain risk factors that can increase the chance of developing ankle sprain. These include [2]:

• Lack of proper physical conditioning, poor muscle tone, contraction of joint capsule and lack of training in the activity being performed all lead to ankle sprain.
• Accidents and other trauma conditions. 
• Obesity can cause increase in kinetic energy, which may exceed the joint stress limits.
• Individuals who participate in athletic activities are thrice as more likely to develop ankle sprains [3].

The exact prevalence rates of ankle sprains are not known, because many cases are self treated, and therefore go unreported. With the available data, it can be estimated that about 23,000 individuals of United States per day seek medical intervention for ankle sprains [4]. In addition, it has also been reported that, female athletes are 25% more likely to develop ankle sprains, than their male counterparts. Along with basketball players, ankle sprain is a common occurrence amongst those individuals who play soccer, football and volleyball.

Ankle sprain develops, when the ankle moves out its normal position, due to certain activities or actions. This causes the ligaments of the ankle to tear, leading to swelling and pain [5]. Ankle sprains are classified into 3 different grades which include:

• Grade I characterized by minor injuries that causes the ligament to stretch, with little swelling and pain. In such cases, the individual is able to stand and bear weight.
• Grade II injuries, wherein there is partial tearing of the ligament, followed by considerable amount of swelling, accompanied by moderate to severe joint instability. In this, the affected individuals have grave difficulty in bearing weight.
• Grade III characterized by absolute rupture of the ligament, severe swelling and severe joint instability. Individuals, who have suffered grade III ankle sprain, are unable to bear weight without pain.

The following steps can be taken to prevent occurrence of future sprains:

• It is necessary to avoid high heels and not overuse the affected ankle.
• Post recovery, the affected ankle can be bandaged and braces can be used if required.
• Strengthening exercises are necessary to strengthen the muscles and ligaments of the affected area.
• Individuals are also advised to wear comfortable footwear and external support while playing [10].

The resulting symptoms that occur usually due to inversion-twist of the ankle are pain, accompanied by swelling of the affected area. The fact that the affected area has undergone inflammation, but the individual can still walk, excludes all chances of occurrence of fracture. Ankle sprain is classified into 3 grades depending on the severity of the condition [1].

• Definition: Ankle sprain is characterized by ligament injury that occurs due to an improper twist, and turn of the ankle. It is a common occurrence amongst athletes, and females are more prone to contract the condition, than males.
• Cause: All actions and activities that cause the ankle to improperly twist and turn can give rise to ankle sprain. Several factors such as accident, injury or wearing uncomfortable footwear, and playing sports can predispose an individual to develop ankle sprains.
• Symptoms: Symptoms of ankle sprain include bruising, swelling, discoloration and pain in the affected region. Individuals are also unable to bear weight, due to which, they experience difficulty while walking.
• Diagnosis: Physical examination of the ankle can be done at the preliminary level. This should be followed by X-rays to rule out fractures. MRI is indicated only when serious and complex injuries are evident.
• Treatment: Application of ice immediately on the affected ankle for 10 to 15 minutes on hourly basis is strongly recommended. Medications to relieve pain and swelling are also given. The affected ankle is covered with ACE bandage, and braces are given for support and to restrict mobility. Surgery is indicated only when there is severe injury to the ligament.

1. LeBlanc KE. Ankle problems masquerading as sprains. Prim Care. Dec 2004;31(4):1055-67. 
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4. Mahaffey D, Hilts M, Fields KB. Ankle and foot injuries in sports. Clin Fam Pract; 1999:1(1):233-50.
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6. van Rijn RM, van Os AG, Bernsen RM, Luijsterburg PA, Koes BW, Bierma-Zeinstra SM. What is the clinical course of acute ankle sprains? A systematic literature review. Am J Med. Apr 2008;121(4):324-331.e6.
7. Frost SC, Amendola A. Is stress radiography necessary in the diagnosis of acute or chronic ankle instability? Clin J Sport Med 1999; 9:40.
8. Saxena A, Luhadiya A, Ewen B, Goumas C. Magnetic resonance imaging and incidental findings of lateral ankle pathologic features with asymptomatic ankles. J Foot Ankle Surg. Jul-Aug 2011;50(4):413-5.
9. Cooke MW, Marsh JL, Clark M, Nakash R, Jarvis RM, Hutton JL, et al. Treatment of severe ankle sprain: a pragmatic randomised controlled trial comparing the clinical effectiveness and cost-effectiveness of three types of mechanical ankle support with tubular bandage. The CAST trial. Health Technol Assess. Feb 2009;13(13):iii, ix-x, 1-121.
10. Garrick JG, Requa RK. Role of external support in the prevention of ankle sprains. Med Sci Sports. Fall 1973;5(3):200-3.