Lateral Ankle Sprain in the Orthopedic Patient
Lateral ankle sprains are the most common sports injury, but can occur with daily activities as well, like tripping on a curb. An ankle sprain is an injury to the ligament that supports the ankle joint. Proper care can minimize the length of injury and down time, as well as prevent reinjury, which is very common.
Ankle sprains are more common in adolescents and teens; however, it is possible for a younger child who is not near the completion of their growth to sustain this type of ankle sprain. Children’s bones are made up of more cartilage than adults and can sustain an injury to the cartilage or bone rather than the ligament.
How does a lateral ankle sprain occur?
Lateral ankle sprains occur when the foot rolls in towards the body. There are three ligaments that support the outer portion of the ankle: the anterior talofibular ligament (ATFL) the calcaneofibular ligament (CFL) and the posterior talofibular ligament (PTFL). Most lateral ankle sprains affect the ATFL and the CFL (see picture).
What is a sprain?
The term “sprain” refers to an injury to the ligaments of the ankle. A sprain usually results in stretching or tearing of the ligaments. The injury occurs when the foot twists and your body weight is forced onto the outer aspect of the foot. This causes the ligaments to stretch and possibly tear.
How will I know if the cartilage or bone is injured in a younger child?
Your child will need to have a careful examination done by your health care professional. If there is a concern for an injury to the cartilage or the bone, ankle x-rays will be taken. It is also possible to have both a fracture and ligament stretch/tear at the same time. Your child’s health care professional will determine which areas have been injured.
What are the symptoms of a sprain?
What is the treatment?
Treatment depends on the severity of ankle sprain. During the first 2-3 days (48 to 72 hours) after the initial injury, the goal is to minimize swelling and pain by remembering PRICE.
P: Protect the injured ankle from further injury. Your healthcare provider will decide what kind of support is needed. This may include crutches, bracing, a CAM boot, cast etc.
R: Rest the injured ankle. Avoid running, jumping, or any activity that causes pain.
I: Ice the injured ankle. Ice should be applied for the first 3 days for 15-20 minutes throughout the day while you are experiencing pain and swelling.
C: Compression. An elastic wrap or ace bandage may be applied to the injured ankle in between ice applications. Do not pull the bandage too tight as this may decrease blood flow to the foot. Unless otherwise directed by your health care team, do not wear the compression bandage at night.
E: Elevation. Keep the injured ankle elevated above the level of the heart as much as possible until swelling improves. It is important to keep the ankle elevated while sleeping at night, also. Blankets, pillows or rolled towels can be used for elevation.
You may use acetaminophen (Tylenol®) or ibuprofen (Motrin, Advil®) to control the pain. Take as directed on the label. Only be used as needed.
What kind of therapy will I need?
A rehabilitation program can start as early as the day of the injury. The goal of rehabilitation is to gradually return to pre-injury activity level. Your healthcare team will discuss the appropriate rehabilitation for your type of injury and when it is safe to resume activities.
Contact your CHOP healthcare team if:
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Your child has pain or swelling that worsens, even with pain medicine, elevation, and ice.
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Your child has numbness, tingling, or weakness in the leg, ankle or foot.
Weekdays:
215-590-1527 if your cast was placed in our Philadelphia, Princeton or Voorhees sites.
If your cast was placed in our King of Prussia office, call 215-590-6919.
Nights, weekends, and holidays:
Call 215-590-1000 and ask the operator to page the orthopedic resident on call.
Reviewed April 2024 by Kate Easby, ATC