How To Tell If Your Annoying Ankle Issue Is Actually A Sprain

Photographed by Rus Anson.
A sprained ankle is one of those injuries that can either seem like NBD or it can feel like the end of the world. Even the word "sprain" sounds like a little tweak, but that's not always the case. If you did something weird to your ankle while running on uneven pavement, or just took a step in an odd way, and still feel some pain days later, then there's a good chance that you sprained your ankle and shouldn't just brush it off as plain old soreness.
Often, knowing whether you've sprained your ankle is as simple as looking at what happened. "You don't just wake up with a sprained ankle, there is almost always an incident," says Alexander Lucci, DPT, ATC, a physical therapist and clinical director at Professional Physical Therapy in New York City. In some cases, you might literally hear a pop when the injury occurs, according to the Mayo Clinic. Then, the first symptoms of a sprained ankle are usually pain, swelling, weakness, difficulty walking or bearing weight, and bruising a few days later, Dr. Lucci says. "Tenderness to the touch on the sides of your ankle, under the bumps, is also a good predictor for a sprain," he says.
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There are levels to a sprained ankle, and they're usually graded (with a number 1, 2, or 3) by your doctor or physical therapist, Dr. Lucci says. "A sprained ankle is when tearing occurs at the ligaments, which are soft tissue fibers made into a band that holds your bones together," he explains. If a few fibers tear, then it's grade 1; if most of the fibers tear, it's grade 2; and if all the fibers tear, you have a grade 3 sprain. Unfortunately, you don't have to be doing anything crazy in order to get a bad sprain; sometimes literally walking can do it.
Next comes the swelling. After a sprain happens, your body will send white blood cells (aka "healing cells") to the area in order to help repair the tissue, Dr. Lucci explains. "These cells, and fluid from the injured blood vessels in the area, make up a majority of the ‘swelling," he says. The injured blood vessels cause the bruising, while the white cells help repair the injured tissue by forming scar tissue, he says.
It's usually pretty easy to treat a minor sprained ankle with PRICE (protection, rest, ice, compression, and elevation) and some physical therapy, but if your sprain is more severe, then you might be referred to an orthopedic surgeon, according to the Mayo Clinic. With a grade 3 sprain, in which all ligaments are torn, it could cause joint instability, which can require surgery and a longer rehab period, Dr. Lucci says.
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That's why it's important to see a doctor who can asses your ankle, figure out if ligaments were injured, and rule out a fracture (which might require an X-ray), Dr. Lucci says. And, in the first couple days, it's crucial to follow PRICE, he says. "Excessive swelling for extended periods can cause atrophy of the muscles around the joint, thus leading to weakness and becoming susceptible to future injury," he says.
It's pretty actually common to re-sprain a previously injured ankle; some studies estimate between 30 and 80% of people who've sprained an ankle will have recurrent sprains, which can lead to other ankle issues, according to the American Orthopaedic Foot and Ankle Society. For that reason, after the sprain heals, progressive strengthening and stretching is encouraged to get your ankle back to normal, Dr. Lucci says.
So, while this may feel like a silly reason to see a doctor, it's important to take it seriously, so you can get back to whatever activity caused the injury in the first place — even if it was just doing nothing.
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