Most ankle sprains occur when the foot is suddenly turned inward, stretching or tearing one of two of the outside ankle ligaments. These sprains occur commonly on an irregular surface. Other contributing factors may include weak or imbalanced leg muscles, a previous ankle injury, or worn out shoes.

The Injury
Ankle sprains are immediately and severely painful and incapacitating. The athlete may actually hear a pop or experience a tearing sensation. Lateral ankle ligaments usually tear in a predictable sequence. A "single-ligament sprain" occurs when the athlete's flexed ankle is inverted or turned inward. If the inversion continues to involve the entire foot, a second ligament tears, producing a "double-ligament sprain." The skin over the injured area swells easily from the leaking, damaged blood vessels.

Diagnosis and Treatment
Sprained ankles should be examined before swelling and muscle spasm set in to mask the signs of injury. The clinical examination can detect a palpable ligament defect and the degree of joint instability. Stress x-rays are used to confirm the degree of instability. Ankle sprains are graded into three degrees of severity. The more severe the sprain, the longer the time it takes to recover from the injury.

First Degree. This injury is the most common and the most minor. The ankle ligaments are stretched but not torn. There is little swelling and no instability. Usually ankle elevation and an ice pack to reduce pain and swelling are all that is necessary. You can expect to be back to your sport within 2 - 3 weeks.

Second Degree. Ankle ligaments are partially torn. The ankle usually swells quickly with some bruising. These sprains are painful, making walking difficult. Treatment is basically the same as for a first-degree sprain, only longer. Immobilization of the ankle in brace, splint, or elastic bandage may be necessary to ensure proper healing of the torn ligaments. Your ankle may require a three to six week rest before you can return to your sport.

Third Degree. This injury is the most serious and the most unstable. The ligament group can be completely torn, resulting in ankle instability. While most of these ankle sprains heal on their own with time, those injuries with gross ankle instabilities must be repaired surgically. Treatment usually involves immobilizing the ankle in a cast or walking brace for up to six weeks. This degree of sprain requires 8 - 12 months to allow the ligament to properly heal.

Summary
Physical therapy is usually recommended to assist you in developing an appropriate set of leg and ankle strengthening exercises that include the use of weights. These progressive stretching and strengthening exercises, if continued over time, will allow you to fully restore your ankle's range of motion and flexibility needed to return to the sport you enjoy.