A sprained ankle is an injury to the ligaments that stabilize the ankle joint. These ligaments are like glue or sellotape that put bones together to form joints.
Being a major joint in bearing our body weights, we are eager for an ankle injury to heal on time so we can get back to our daily activities.
This article will tell us how long it takes for a sprained ankle to heal and how some intrinsic and extrinsic factors may prolong the healing process.
How Long Does A Sprained Ankle Take To Heal?
The recovery time of an ankle sprain is dependent on the severity of the injury. There are 3 grades of injury which shall be explained further. To help us understand the concept better, let us imagine our ligament is a rubber band.
When you consistently stretch a rubber band, with time, it may not be as elastic as it used to be. This scenario applies to a grade 1 ligament injury in which the ligaments in the ankle are overstretched. There is a bit of pain, swelling, and tenderness. The joint may still be stable and you can still bear weight on the affected ankle. This grade of injury takes about 3 weeks to heal completely.
The rubber band may then develop a hole in it but with care, it can still be used. In a grade 2 ankle ligament injury, some of the ligaments are torn and some are intact. There is pain, swelling, joint instability, and difficulty standing on the affected ankle. Crutches are usually recommended to avoid weight bearing on the affected leg. This takes about 6 weeks to 12 weeks for complete healing.
A cut rubber band is not of use to you anymore except you want to tie the ends together to make it useful again. A grade 3 ligament injury is the most severe form of ligament injury. In this grade, all the ligaments are torn and they usually require surgery. Because of the surgery, they take a longer time to heal and adjust to the new structure that has been attached to help with the healing process. This may take 4 months to 12 months to heal.
What Factors Could Prolong The Healing Time?
Some factors affect the healing time of a sprained ankle. These factors are:
1. Not Seeing A Doctor Or A Physiotherapist On Time
When someone sprains their ankle, they usually try to treat the ankle themselves by standing on the injured ankle or applying heat at the initial stage of the injury or simply ignoring the pain.
This causes more injury to the ligament and may turn a grade 1 sprain to a grade 3. When the symptoms of an ankle sprain become unbearable, they start going to the hospital.
Not seeing medical personnel in time can increase the severity of the injury which in turn affects the healing time. Imagine an injury that could have healed in 3 weeks now requiring surgery and healing after a few months.
2. General Health
Health, they say, is the total well being of the body without any form of a disease. This means that some environmental or hereditary factors may affect our health. Smoking, for example, is not a disease but has been shown to affect the recovery time of ligament sprains. So an injury that should heal in three weeks may take a longer time.
How Can An Ankle Ligament Get Sprained?
The ankle is a hinge joint that connects the lower leg to the foot. The ankle can move up and down and from side to side. The ankle joint is formed by 3 bones; The tibia, the fibula and the talus that is found on the heel bone. These bones are joined together by ligaments.
These ligaments are:
- Medial collateral or deltoid ligament, which joins the tibia to the talus bone in the foot
- Lateral collateral ligament which is made up of 3 ligaments that attach the fibula to the talus and calcaneal bone also known as the heel bone
When the medial collateral ligament is injured, it is known as an eversion ligament sprain because the foot turns outwards and this is not very common.
Most people with ankle sprains report that the foot turns inwards. This affects the lateral collateral ligament which is the most common ligament to be injured in a sprained ankle. This is known as an inversion ligament sprain.
These ligaments can be turned inwards or outwards by:
- A sudden twist of your ankle when missing a step
- Jumping off a high place and losing your balance when you land
- Walking or exercising on an irregular surface like walking on the road and you step into a hole
- When someone steps on you during a sporting activity
- Wearing heels and losing a step
How Do I Know It Is A Sprain And Not Something Else?
- There will be a pain at the ankle joint especially when you try to move the ankle
- There is swelling at the joint which is due to an increase in blood flow and the clotting process to heal the injury. If the medial ligament is injured, there will be swelling at the inner part of the ankle and if it is the lateral ligament, the swelling will on the outer side of the ankle
- Difficulty moving the ankle joint or trying to bear weight on the ankle
- There may be bruising or redness at the ankle joint
- X-rays, CT scan or an MRI may be advised by the doctor to ensure that there is no associated fracture or dislocation that may affect the recovery time. It also helps determine the severity of the injury and the integrity of the ligaments, tendons, and muscles.
Can It Be Avoided?
Accidents are unplanned events but some steps can be taken to avoid ankle injury. Some of these steps include:
- Maintain an active lifestyle. Exercising regularly will strengthen the muscles you are working on. Walking for an hour every day strengthens the muscle in the legs. If the ankle should unexpectedly twist, the strengthened muscle can help support the ligaments and stabilize the ankle for a while and help speed up recovery.
- Wear the right shoes. Do not wear a 6-inch heel if you know you cannot walk comfortably in them. Comfort over fashion.
- If you have injured your ankle before, an ankle brace can be worn to avoid re-injury to the ankle especially while doing a sporting activity.
- Ensure you are working out on a well-leveled surface.
- Strengthen your ankle muscles. Exercises are usually prescribed by the physiotherapist.
How Is It Treated?
The PRICE treatment is recommended for the first 72 hours of the injury. The acronym stands for:
P – Protect the ankle from further injury. If you are an athlete, all sporting activities should be avoided until the injury has completely healed and resumption of activity is approved by your doctor or physiotherapist
R – Rest the ankle joint. This means using an ankle brace or a walking aid like crutches or a walking frame to let the ankle rest from its normal body function.
I – Ice the joint in order to relieve pain and reduce swelling at the ankle joint. Ice causes the blood vessels to shrink and this reduces the flow of the pain- causing hormone. An ice pack or crushed ice in a damp towel placed on the ankle for 15 minutes every four hours will do the trick.
C – Compression has been shown to reduce swelling by wrapping an elastic bandage around the ankle joint to reduce swelling.
E – Elevation is the positioning of the ankle while you are at rest. The ankle should be elevated at all times. This is because gravity can cause a pooling at the ankle and since the ankle cannot be moved to assist in pumping blood against gravity, it will increase swelling. It is usually advised that the ankle should be raised above the heart level to speed up a reduction in swelling.
Anti-inflammatory medications are given orally or topically. These medications are prescribed by the doctor for a certain period of time. Do not go against the prescription as it may cause harm to other parts of your body.
The topical gel that is usually recommended is a ‘cold’ gel which are gels with anti-inflammatory contents such as ibuprofen and diclofenac and the ointment may later be changed to a ‘hot’ gel which has methyl salicylate as the major component.
Physiotherapy prepares the injured ankle to return to its pre-injury phase. The physiotherapist will assess the ankle and draw up realistic goals with you with the ultimate goal being to make the ankle act like it was never injured.
The goals of the physiotherapist will be to:
- Relieve pain which can be with ice, heat or electrical modalities
- Increase muscle strength which can start from static exercises and as the injury heals, the exercises change and increase
- Prevent joint stiffness which may occur because you are not moving the ankle
- Reduce swelling with ice, exercise or teaching positions that can help
- Train your balance and agility especially if you are an athlete
- Return the ankle to its almost original state
The physiotherapist will also give appointments to follow up on how the ankle joint is fairing and will also educate you on proper care of the ankle and avoid complications that may arise if not well adhered to.
What Complications May Arise If Not Well Treated?
- Recurring ankle sprain
- Ankle joint stiffness
- Muscle weakness
- Difficulty walking or change in walking pattern
- Sometimes, dislocation of the ankle joint as the ligaments may get weak and not be strong enough to keep the bones in place.
- There is a tendency to compensate because of an injured ankle. By compensating, I mean bearing weight on the unaffected ankle and since one ankle is not used to working alone, the unaffected ankle may begin to hurt and may cause a sprain as well.
A sprained ankle recovery time depends on a lot of factors. You may be told that it may take 3 weeks for a sprain to be healed but other things may either slow down or speed up the process.
Ligaments are delicate structures and must be cared for properly to avoid any reinjury or difficulty walking or gaining your balance.