What is an ankle sprain? An ankle sprain is a laceration of the ligaments around the ankle joint. The ligaments are some of the tough fibrous tissue that connects the bones across the joint. A ligament tear can be a very minor fibrous strain injury or a complete rupture of the ligament. The most common injury is to the lateral ankle ligament, the part of the ligament that is located on the outside of the ankle, followed by the so-called medial ligament, or deltoid ligament, which is located on the inside of the ankle, and the least common is a joint sprain of the lower tibiofibular joint between the two bones of the lower leg (tibia and fibula) near the ankle, also known as a “high ankle sprain. “The least common is a joint sprain of the lower tibiofibular joint between the two lower leg bones (tibia and fibula) near the ankle. How to diagnose ankle sprain? 1. Medical history: Generally, everyone will know when the ankle is sprained and can describe the direction of the ankle sprain. However, if it is a situation such as a car accident, it is difficult for people to recall how the injury occurred and they only know that their foot was injured. 2. Physical examination: There will be pressure and pain in the area of the ligament and swelling in the ankle joint. Usually the ligament will show laxity, but sometimes the pain is more intense and causes protective muscle spasms, which instead conceal the ligament laxity. 3.X-ray: If the local swelling is obvious and there is pressure pain on the bone, we should beware of whether there will be ankle fracture, and we need to take X-rays to rule out ankle fracture. 4. MRI: If the swelling is very severe and there is a suspicion of articular cartilage damage in the ankle joint, an MRI can be considered. However, MRI does not help the doctor to determine which ligament sprains can be treated conservatively and which require surgery, so it is not essential if articular cartilage injury is not considered. What is the treatment? The first treatment consists of rest, cold compresses, compression bandages and elevation of the injured limb. The goal of these treatments is to reduce the pain and swelling. Some pain medications such as fen-phen or some other new long-acting anti-inflammatory pain medications such as Cilazol may also be taken. Recent studies have shown that for second or third degree ligament sprains, if the affected limb is immobilized in a cast for 10 days, by three months, these patients recover better than those with other treatments, but after three months their results are not very different. If a cast is not used, brace immobilization is a good option, while walking braces or compression taping are less effective. Physical therapy The most important part of treatment for ankle sprains is physical therapy under medical supervision to re-establish muscle strength and a sense of balance in the ankle joint. Once the ankle is sprained, the muscles around the joint are weakened by the slowed nerve reflexes and require some graded balance and responsiveness training to restore function, such as mini-trampoline or balance board training. Sometimes “old” ankle sprains that do not heal over the years can be restored with this type of training. How long does it take to heal? For minor ankle sprains, the soreness will usually heal within a few months, while severe ankle sprains or complete ligament tears may require surgery to heal. But in any case, you should still try 3 months of planned rehabilitation exercises under the guidance of your doctor first, and if conservative treatment fails, it is not too late to decide on surgery.