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Sprained ankle facts:

Updated: Dec 26, 2020

Over 80% of sprained ankles are inversion injuries. It can happen during running straight, cutting, walking downhills, or on uneven surfaces.

Clinically there are three grades of ankle sprained:

Grade 1; mild, stable, and single ligament involved. There is minimal swelling, no or little limping during walking, minimal functional loss, and/or difficulty hopping.

Grade 2; moderate and stable. This sprained ankle grade includes a large spectrum of injury and may result from mild to moderate instability. Signs and symptoms included localized swelling, limp with walking, inability to raise toe, hop, and running.

Grade 3; severe and unstable. This sprained ankle grade includes significant instability, diffuse swelling on both sides of the Achilles tendon, tender on both sides of the ankle, unable to bear weight fully due to pain, and initially almost complete loss of range of motion.

The grading of sprained ankle

Step to follow after sprained ankle injury:

After suffering from a sprained ankle, you can reduce pain and swelling by following the RICE procedure:

  1. Rest the injured part; you can sit down to let the weight off your foot.

  2. If possible, ice the ankle; you can apply packed snow or soak your foot in cold water stream/river.

  3. Compressed the ankle with an elastic bandage and a horseshoe pad to the affected malleolus. (Check your circulation after wrapping your ankle by pressing on your big toe until it turns pale, release, and blood flow should return straight away. You should not feel any numbness or tingling sensation)

  4. Elevate the injured part higher than your heart.

Continue icing the ankle for 15 minutes every 2 hours in the first 24 hours. After the initial 24 hours, icing 3 times per day should be sufficient. Maintain compression for the first 48 hours after injury; you can remove the compression bandage and the horseshoe pad during icing.

Please seek medical help if there are severe pain and swelling.

You can prepare the answer to the following questions to help the medical practitioner to implement the best treatment protocol for you after sprained ankle:

  1. What was the injury mechanism (e.g., how did the accident happen, which direction did you sprained your ankle)?

  2. Where was the pain initially?

  3. Did you hear a pop, snap, or crack sound?

  4. Were you able to walk immediately after the injury?

  5. Did you continue the sports event (and for how long)?

  6. Did the ankle feel unstable?

  7. Did the ankle swell up immediately (or later in the day or the next morning)?

  8. What treatment was applied immediately? Later?

  9. Have you had a history of sprained ankles (both ankles)?


Reid, D.C.: Sports Injury Assessment and Rehabilitation. New York, Churchill Livingstone 1992, p.226.

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