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Ask the Expert: Dr. Martin O’Malley, Orthopedic Surgeon, Answers Your Questions About Ankle Sprains

Wrapping foot and ankle

Q1. What is the difference between an ankle fracture and an ankle sprainAn ankle sprain is a tear of the ligaments- soft tissue that hold the bones together, like rubber bands. An ankle fracture is an actual break in the bone.Most ankle sprains heal without surgery, while most ankle breaks require surgery to realign the bones and make sure they heal in the correct position.

Q2. Are all ankle sprains the same? Most ankle sprains happen to the same ligaments. About 90 percent of ankle sprains involve the lateral ligaments, which are on the side of the ankle, facing outside. These ligaments connect the fibula- the small ankle bone- to two bones in the foot called the talus and calcaneus. A variant of this injury is called the “high” ankle sprain that tears the ligaments that hold the two lower leg bones? the tibia and fibula? these take much longer to heal.

Q3. What’s best for an ankle sprain: heat or ice? Treatment of an acute ankle sprain follows the ‘RICE’ protocol, which stands for:  Rest, Ice, Compression and Elevation. If you suspect you have an ankle sprain, it is best to consult with an orthopedic doctor. Typically, patients should ice the ankle for the first 3-5 days after the sprain, but then heat the area before activity and then ice it after activity.

Q4. I’m an avid runner, should I keep running through an ankle sprain? If you are a runner and have a mild ankle sprain you may be able to keep running if you are comfortable. However, you should see your doctor if you cannot walk, if swelling persists despite icing and resting, or if pain does not go away after 48 hours.

Q5. I keep spraining my ankle over and over? Is there a reason why it happens over and over again? Is there something I can do to prevent it from happening? Recurrent ankle sprains could be caused by injuries to ligaments in the ankle that did not heal properly. The ligament may have healed in a stretched position, causing abnormal motion in your ankle. One cause of repeated sprains is poor muscular coordination of the outside ankle tendons, which connect muscles together. This is common after an ankle sprain and is usually treated with physical therapy and an ankle brace during activity. Some patients also have a high arch, which can put them at risk for recurring ankle injuries. This can be treated with an orthotic device in the shoe.

Q6. Can I get arthritis from spraining my ankle? Chronic ankle instability from repeated sprains can lead to arthritis. If you keep getting ankle sprains, you should consult with your doctor and consider surgery to correct the ankle ligaments in order to prevent arthritis.

Q7. How long does an ankle fusion last under normal circumstances? The treatment for ankle arthritis is an ankle fusion- when the bones of the ankle are fused together or an ankle replacement- replacing the damaged joints with a prosthesis. Fusion can last a lifetime but may cause arthritis to occur in joints below your ankle. Ankle replacements last 10-12 years.

The information provided in this blog by HSS and our affiliated physicians is for general informational and educational purposes, and should not be considered medical advice for any individual problem you may have. This information is not a substitute for the professional judgment of a qualified health care provider who is familiar with the unique facts about your condition and medical history. You should always consult your health care provider prior to starting any new treatment, or terminating or changing any ongoing treatment. Every post on this blog is the opinion of the author and may not reflect the official position of HSS. Please contact us if we can be helpful in answering any questions or to arrange for a visit or consult.