Ankle sprains are extremely common, with an estimated two million per year in the U.S. Oftentimes, they present little concern for long-term well-being and can even heal themselves. Other times, it’s smart to see an ankle specialist for an X-ray to see what’s going on internally to prevent ongoing pain and the risk of injuring the ankle again later in life.
Dr. Geoff Watson of Bone and Joint Institute of Tennessee is an orthopaedic surgeon specializing in foot and ankle care. Here’s what he has to say about ankle injuries and when to see a specialist.
What is an Ankle Sprain?
An ankle sprain happens when you tear the ligaments around the ankle. Three main ligaments hold the ankle stable: Two are on the outside – Anterior TaloFibular Ligament (ATFL) and CalcaneoFibular Ligament (CFL) – with the Deltoid ligament on the inside. Usually when you tear the ankle ligaments, you tear them in that order – ATFL, CFL, then the Deltoid.
There are three grades of severity for ankle sprains, and generally speaking it goes by how many ligaments you damage. In a Grade 1 sprain, you’ll just tear the ATFL whereas in a Grade 2 sprain you tear both the outside ligaments. At the top of the scale, a Grade 3 sprain is severe because it injures all three ligaments.
What Are The Signs It’s Time to See an Ankle Specialist?
Before you learn about signs it’s time to see an ankle specialist, understand that recovery times for ankle sprains will vary based on severity and how an individual’s body reacts. Most of the time, a mild ankle sprain will recover in a couple of days. Grade 2 sprains can take a week or two. Grade 3 sprains can take 4-6 weeks to fully recover.
If your ankle still hurts after about a week or you experience any of the following symptoms, it’s a good idea to see an ankle specialist.
- Clicking
- Locking
- Catching
- If the ankle isn’t weight-bearing 24 hours after the injury
Some ankle sprains also involve a broken bone. That broken bone might need protection (or even surgery in some instances), which is why it is important to seek immediate medical care.
While some people say you’d be better off if you’d broken your ankle than sprained it, that isn’t always the case and it depends on how bad the fracture is. It comes down to how much damage is done to the joint. You can sprain your ankle and chip off a little piece of bone in your ankle that has cartilage attached to it. This is called an osteochondral lesion, and that can be a big problem if not properly taken care of because it can damage other cartilage and ultimately lead to arthritis.
The main purpose of getting your ankle looked at when you have an ankle sprain is to make sure you don’t have a more serious injury masked by the pain from the sprain. The sooner you have it looked at, the easier it is to prevent pain and further damage to your ankle.
Who Generally Suffers from Ankle Sprains?
The most common demographic to suffer an ankle sprain is young, active, athletic individuals. Generally, these are teenagers through adults in their mid-30s. But people in all age groups can suffer ankle injuries. Kids don’t typically get ankle sprains since the growth plate is the weakest link, so ages 14 and up is when you often start seeing them occur.
What Are Some Potential Long-Term Impacts Without Treatment?
When ligaments tear , mechanically they can no longer function to keep your ankle stable. The body could heal that on its own, and it could scar at the same length as it was before. In that circumstance, that’s perfectly fine because you don’t have any laxity in your ankle. But some patients heal with that ligament now longer than normal, which increases the chance of spraining it again. Down the road, those loose ligaments can also create arthritis because that shear stress to the joint can cause wear.
Most ankle injuries do not require surgery. However, severe injuries might need surgery if it had an associated injury, such as an osteochondral lesion. Generally, ankle specialists first try to allow the injury to heal conservatively with a boot or brace and physical therapy. In about >90 percent of those injuries, the boot or brace will protect the injured ankle and therapy can help to compensate by strengthening the muscles around the ankle.
The Bottom Line:
Because ankle sprains are so common, it can lead patients to put off care, hoping the injury will heal on its own. A recent patient of Dr. Watson’s had suffered multiple ankle sprains in their lifetime, but stated they felt that going to the emergency room was a waste because during the previous visit they’d been sent home to heal on their own. Now two months into experiencing pain from the injury this time around, they knew it was time to see someone.
If your ankle sprain isn’t getting better within a week, it’s a good idea to get an X-ray to make sure it isn’t something that needs correction. This can shorten your recovery time and get you back to leading a pain-free life doing things you love.
About Dr. Watson
Geoff Watson, M.D., is a board certified orthopaedic surgeon specializing in treatment of the foot and ankle. He is a graduate of the University of Tennessee and a native of Knoxville. In 2009, he received his medical degree from the University of Tennessee Health and Science Center, and then completed a residency at the University of Mississippi Medical Center in Jackson. Dr. Watson continued his fellowship training in foot and ankle at the Hospital for Special Surgery in New York, NY, and has assisted in orthopaedic care for the Ole Miss Rebels, New York Knicks and New York Giants.
To learn more about foot and ankle injuries, visit our website at www.BoneAndJointTN.org/foot-and-ankle. To schedule an appointment with Dr. Watson, call (615) 791-2630 or schedule an appointment online.
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