Ankle sprains are a very common ankle injury but should be taken seriously and be treated promptly. Sometimes they are misdiagnosed as just a minor ligament tear, which is the simple definition of a sprain injury, but a number of different injuries could be present, that may need a different treatment than a typical sprain. Also, it is important to seek immediate atttention for early treatment so that these injuries heal properly, otherwise continued pain and ankle instability can ocur, leading to recurrent pain and ankle sprain type injuries in the future.
INVERSION ANKLE SPRAINS
The most common type of ankle sprain is an "inversion" ankle sprain, thereby which the foot is in an inverted position on the leg at the time of injury, or turning toward the midline of the body. Most people commonly call this "rolling your ankle". They usually involve the partial or complete tearing of one or more ligaments on the outside of the ankle joint, called the lateral collateral ligaments. This group of ligaments, starting with the most common ligament injured first, is comprised of the ATF (anterior talo-fibular) ligament, CFL (calcaneo-fibular) ligament, and the PTF (posterior talo-fibular) ligament.
OTHER ANKLE SPRAINS
Other sprains of the ankle joint can occur. One can also sustain an injury on the inside or medial side of the ankle where the deltoid ligaments are found. Deltoid ligament sprains will present with more pain and swelling on the inside of the ankle, and are usually called medial ankle sprains.
High ankle sprains occur at the ligament between the leg bones above the ankle joint called the AITF (anterior inferior tibio-fibular) ligament. It is more common in football injuries where there is an external rotation force of the foot on the leg at the ankle joint. It is sometimes overlooked and treated as a typical inversion ankle sprain and usually has a longer recovery.
A varitety of other injuries can occur during an ankle sprain event. This is why it is imperative to seek professional attention from a foot and ankle specialist as soon as possible and have the proper imaging performed. Sometimes a simple ankle X-ray in the ER or Urgent Care can be misleaeding if there soft tissue damage that must be detected on an MRI. A doctor specializing in the foot and ankle can determine which type of injury it could be on the first visit, and perform or order the proper imaging without delay, which could prevent misdiagnosis, further damage, and improper healing.
Ankle fracture: fractures can occur at the fibula, tibia, and talus bones.
5th metatarsal fracture: fractures can occur at the base of the 5th metatarsal bone in the foot. Foot X-rays are therefore sometimes necessary upon initial care.
Cartilage injury: the cartilage of the talus bone which is on the bottom of the ankle joint can sustain damage during an ankle sprain injury.
Peroneal tendon tear: there are two tendons that course around the outside of the lateral ankle that attach the peroneal muscles on the outer lower leg to bones on the foot, and these can become partially torn or completely ruptured.
Nerve injury: nerves on the outside top of the foot can be stretched during a sprain and can become irritated and painful for several months after an ankle sprain.
All of these types of trauma can be diagnosed properly by a foot and ankle specialist. It is important to obtain an evaluation and proper treatment soon after an ankle sprain for the best outcome.