I. What is an ankle sprain? An ankle sprain is a laceration of the ligaments around the ankle joint. Ligaments are some of the tough fibrous tissues that connect 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 is a lateral ankle ligament injury, which is a tear of the ligament located in the lateral part of the ankle joint; the next most common is a tear of the so-called medial ligament, or deltoid ligament, located on the medial side of the ankle joint; 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 joint, also known as a “high ankle sprain. It is also called “high ankle sprain”. How to diagnose ankle sprain? 1. Medical history: Generally, we all know about ankle sprains and can describe the direction of the sprain. However, if it is a situation such as a car accident, it will be difficult for people to recall how the injury occurred and they will only know that their foot was injured. 2. Physical examination: There will be pressure and pain in the area of the ligaments and swelling in the ankle joint. Generally the ligaments 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, you should beware if there is an ankle fracture, and you need to take X-rays to exclude ankle fracture. 4. MRI: If the swelling is 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, therefore, MRI is not essential if articular cartilage injury is not considered. Third, how to treat? The first treatment includes rest, cold compresses, compression bandages and elevation of the injured limb. The purpose of these treatments is to reduce the pain and swelling. You can also take some pain medications, such as Fenbid or some other new long-acting anti-inflammatory pain medications, such as Cilazol. 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 also be restored through such training. How long does it take to heal? A mild ankle sprain will usually heal within a few months of soreness, while a severe ankle sprain or complete ligament tear may require surgery to heal. But in any case, you should still try 3 months of planned rehabilitation exercises under the guidance of a doctor first, and if conservative treatment fails, it is not too late to decide on surgery.