Types of Sprains
Grade 1, 2, 3
Ligaments stabilize joints during motion and rest as well as limit directional movement. When a joint, such as the ankle, moves too forcefully in a direction not allowed by the ligaments there is great risk of injury. The degree of the injury depends on the severity of the trauma sustained by the ankle ligaments. In most cases an ankle sprain does not warrant a trip to the doctor but it may become necessary if the symptoms do not diminish. Furthermore, a proper diagnosis of a grade 1, 2 or 3 sprain will allow for a more tailored treatment program. A grade one sprain, which is the mildest and most common, consists of minimal pain and swelling around the ankle and is a result of the ligaments being stretched without tearing the dense fibers of the ligament. Second-degree sprains involve minor tearing of the ligament without complete rupture and because of the torn tissues and blood vessels there is more swelling from the excess blood. Third-degree sprains are the most traumatic and painful with a complete rupturing of the ligament. There will be severe inflammation and potential for bruising around the area and depending on the cause of the injury, the ankle may look twisted in more serious cases. Putting weight on the ankle will be very painful, and if this is the case you should see your doctor immediately and try not to put any pressure of any kind on the injured ankle. A third-degree sprain requires extensive rehabilitation and may include surgery.
Inversion ankle sprains, the most common sprain, occurs when the foot rolls over onto the lateral side, in an inward motion. This motion puts added stress on the ligaments of the outer ankle and often this stress proves to be too much and you will suffer a sprain. Pain is always felt on the outside of the ankle, simply because that is where the injury has occured. There are three ligaments, the anterior and posterior talofibular ligaments and the calcanefibular ligament, that make up the lateral collateral ligament (LCL) on the outside of the ankle; these are the ligament(s) that are stretched or torn during an inversion sprain.
Eversion ankle sprains occur much less frequently than inversion injuries. While eversion sprains do occur it is just much more difficult to twist your foot outwardly when taking part in regular and sports related activities. Eversion sprains involve the ligament on the inside of the ankle, known as the deltoid ligament.
High Ankle Sprain
A 'high' ankle sprain, also known as syndesmotic sprain, is an inury to the syndesmotic ligament that joins the tibia and fibula bones of the lower leg. The distinction exists because a "high" ankle sprain occurs above the ankle joint and is more severe than a sprain of the joint ligaments.
'High' ankle sprains typically occur when the foot is forced upward and outwardly. Syndesmotic sprains are also subject to degrees of trauma but they may effect activity differently than joint sprains especially when it comes to putting weight on the ankle. Severe sprains, such as serious second degree and third degree sprains of the syndesmotic ligament, may allow for the bottoms of the tibia and the fibula to spread apart which is called diastasis. Sprains of this type are serious in terms of rehabilitation time but can usually be treated similarly to typical ankle sprains. With regard to surgery it will depend on the stability of the injured ankle and whether or not diastasis is present.
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