Ankle Sprains

What is an ankle sprain?

An ankle sprain is the stretching of one or more ligaments that attach to the bones of the ankle. In severe cases, the ligament is torn. Ligaments are elastic-like bands attached to bones that help move joints.

Ankle Sprain
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An ankle sprain is an injury to the small ligaments in the ankle. Sprains often occur during a fall when the foot is twisted onto its outer edge.
An ankle sprain is a common injury in children. Your child may have twisted his ankle playing sports or landed on his foot in a strange way to cause this injury.

Ankle sprains most often occur on the outside area of the ankle. This means the ankle is twisted inwards. The ankle can also twist outwards.

A mild injury is a strained ligament with a little swelling. A severe injury is tearing of the ligament with more swelling.

Signs and symptoms of an ankle sprain

After an ankle injury, your child may have:

  • a hard time walking

  • mild to severe pain

  • less movement in the ankle

Other signs may include:

  • swelling and bruising around the front and side of the ankle

  • tenderness around the areas of the bones

  • little or no tenderness over the bony prominences

Managing an ankle sprain

If your child's ankle is stable, there is little pain and there is no tenderness or soreness on the bone, you can take care of your child at home. Call your child's doctor from there.  

If your child's ankle is unstable, in a lot of pain or there is tenderness or soreness on the bone, your child will need to see a doctor. The doctor will do tests to find out how much damage is done to the ankle.

Taking care of your child at home

Rest, ice, compression, elevation

For the first 24 hours, rest the ankle.

While your child is awake, put ice packs onto the swollen or sore area for 30 minutes every 4 hours for 3 days.

Raise (elevate) the ankle above the level of the heart to help to reduce swelling.

Ibuprofen, support bandages, and crutches

Your doctor may advise you to give your child ibuprofen​ (Advil, Motrin, or other brands) to manage the pain and reduce swelling.

Support bandages or an aircast can reduce swelling and prevent further injury to the ankle.

Your child may use crutches if he has trouble walking.

Strengthening exercises

If your child has a minor ankle sprain, he may begin ankle exercises as early as 48 hours after the injury. These exercises include moving the ankle through its natural range of motion by bending the ankle backwards, forwards, inwards, and outwards. To improve balance, it is important to stand on the injured leg. Light weight-bearing and easy walking helps healing.

The injury can take more than 2 weeks to improve. Complete healing can take as long as 10 to 12 weeks.  

When to see a doctor

If there is still a lot of difficulty in walking and ongoing pain after 48 hours, speak to your doctor again. More exercises and physiotherapy may be necessary.

Returning to sport

Your child can return to sport when there is full range of movement and full strength in the ankle. You can test ankle strength by asking your child to hop on the injured leg 5 times. Check if your child shows signs of pain or is unsteady while hopping. Also, see if your child can run easily in a little zigzag.

Returning to sports too early can lead to a higher risk of further ankle injury. Without a complete and full recovery, your child may have long-term problems. Warm-up exercises and lace-up support can prevent further ankle injury. Before returning to highly competitive sport you may want to see a doctor who knows athletic and sport-related injuries.

Key points

  • Ankle injuries can cause pain and swelling.

  • Healing requires time and patience.

  • Exercises improve ankle healing.

  • Severe injuries should be looked at by a doctor who knows bone and joint injuries.

  • Returning to sports too early can cause long-term problems with the ankle.

Srijana Gautam, BSc, MBBS, MRCPCH, DTM&H

Janine A. Flanagan HBArtsSc, MD, FRCPC

11/16/2009

Ivins D. Acute ankle sprain-an update. American Family Physician 2006;74:1714-20.





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