On a Tuesday evening in September 1994, after rebounding the basketball during a varsity basketball game, I heard a loud “crunching” sound as my right foot landed on top of my opponent’s foot.

Immediately after hearing the sound, I felt an intense burning sensation with pain radiating around my
ankle and up the lateral side of my leg. The pain was so paralyzing that I was unable to turn and pivot or
pass the ball to any of my teammates. Instead, I signaled “time-out” to the referee, fell down on the court
clenching my ankle, and grimacing in pain. My teammates, coach, and the athletic trainer rushed to my side to lift me up and carry me to the bench. As I tried to lightly place my right foot on the floor to walk,
my ankle kept buckling. When we finally made it to the sidelines, the trainer tightened my high-top
sneaker to supply more support and to prevent my foot from swelling any further, she then elevated my
right leg, and taped two large bags of ice to my ankle.

By half-time, my foot was throbbing and the pain was so unbearable that I asked my parents to take me
home. After arriving home, my ankle was so swollen that I needed to remove my shoelaces in order to take my shoe off. By morning, my ankle swelling had become severe and so stiff that it had turned inward, like a clubbed foot. I quickly called my mom at work to update her on my situation. She rushed home and took me to the nearest emergency room. I was evaluated and X- rays were performed. The physician diagnosed me with a grade 3 ankle sprain, which is the most severe sprain. He said that I was better off breaking my ankle, recommended that my right ankle be placed in a short cast, gave me properly fitting crutches, prescribed medication for my pain, and discharged me home.

My sprained ankle caused me to miss much of my junior basketball season. By late January, my cast was
removed, and I began rehabbing every muscle and ligament in my right leg, because they had atrophied,
after school daily. The exercises were grueling in the beginning, but with hard work and dedication, I was
able to play in the last few games of the season.

To learn about ankle sprains, read the information below to learn why they are the #1 reason for missed
participation in athletics.

Causes

● Making a rapid shifting movement with your foot planted.
○ Often the ankle rolls outward, and the foot turns inwards causing the ligaments on the outside of the ankle to stretch and tear.
○ Or the ankle rolls inward, and the foot turns outward (damages the ligaments on the inside of the ankle).

● Occur when the strong ligaments that support the ankle stretch beyond their limits and tear.
● Severity depends on the number of ligaments involved and the extent to which the ligaments are torn.

● Ankle sprains are graded on a scale of 1 to 3:

  1. Simple stretched or microscopically injury to the ankle ligaments
  2. Partially torn ligaments, increased swelling and stretching
  3. The most severe pain means the ligaments have torn completely and/or possibly even off the bone.

Signs and Symptoms

● You feel pain at once at the site of the tear.
● The ankle starts to swell immediately and may bruise.
● The ankle may be tender to touch, and it hurts to move it.
● Severe sprains: you may hear or feel something tear, along with a pop and a snap.
● Extreme pain at first and will not be able to walk or put weight on your foot.
● The more pain and swelling you have, the more severe your ankle pain is and the longer it will take to heal.

Diagnosis:

● Physical exam by physician or general practitioner
● X-rays to make sure no broken bones in the ankle or foot

Treatment

● Most ankle injuries heal with ice, elevation, OTC NSAIDs, and simple rehab.
● If your ankle is still swollen or painful for several weeks despite icing or you have difficulty putting weight on your ankle, you may need to be evaluated to ensure that you do not have a severe ankle sprain or fractures.
● If symptoms do not improve with conservate non-operative treatment, you may need surgery to repair or reconstruct the injured ligaments.

Complications

● Without proper treatment and rehab a chronic or untreated severe sprain can weaken your ankle, making it more likely to reinjure it again.
● Repeated ankle sprains can lead to long term problems:
● Chronic ankle sprains
● Arthritis
● Instability

Figure 1: Types of Ankle Sprains

References

American Academy of Orthopaedic Surgeons. (2021). Sprained Ankle. https://orthoinfo.aaos.org/en/diseases–conditions/sprained-ankle/

Pepermpron. (2022). [Illustration]. Types of Ankle Sprains. https://www.shutterstock.com/image-vector/injury-talo-fibular-foot-treat-high-1907837989

Young, C.C (2019). Ankle Sprain. https://emedicine.medscape.com/article/1907229-overview.

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