Maybe. If it is, what do you need to do?  Do you need to see a doctor, the athletic trainer, or go to the emergency room?

What is an ankle sprain?

An ankle sprain is a partial or complete tearing of the ligaments that stabilize your ankle. There are three main ankle ligaments on the outside of your ankle, the anterior talofibular ligament (ATFL), the calcaneal fibular ligament (CFL), and the posterior talofibular ligament (PTFL).  The inside of your ankle has one main ligament with two parts, the deep and superficial deltoid.

Should I go to the hospital or doctor?

If you can't take more than 4 steps, stand on each leg twice, or if you are tender on the outside or inside bones of your ankle (the lateral or medial malleolus), tender on the bone on the outside of your foot (metatarsal) or tender over your Achilles tendon or in the front just above your ankle (syndesmosis) your should get x-rays and be examined by a doctor.

How bad is it?

We normally grade ankle sprains as a grade 1, 2 or 3.  A grade 1 is slight stretching and some damage to the fibers of the ligament, usually the ATFL. Grade 2 is partial tearing of the ligament, and a Grade 3 is complete tearing of the ligament(s)

What do I do next? (RICE):

• Rest your ankle by not walking on it.
• Ice should be immediately applied. It keeps the swelling down. It can be used for 20 minutes to 30 minutes, three or four times daily. Combine ice with wrapping to decrease swelling, pain and dysfunction.
• Compression dressings, bandages or ace-wraps immobilize and support the injured ankle.
• Elevate your ankle above your heart level for 48 hours.

Recovery:

After the initial pain and swelling improve, usually about a week, the next step is to regain your ankle motion, strength and flexibility.  Next you need to gradually return to cutting activities. Most grade 2 or 3 ankle sprains damage the proprioception fibers (balance) in your ankle and work with a physical therapist or athletic trainer should help you prevent further sprains, and will help you regain your balance and stability. 

Prognosis:

Most ankle sprains resolve without further problems.  (About 90% of Grade 3 sprains do well with appropriate rest, recovery and therapy.)  Why don't they all do well?  Some people have repeated sprains and instability.   This can be caused by a lack of physical therapy, a stretching of the ligaments, or a painful tendon tear or cartilage injury that makes the ankle give out.  If you have multiple ankle sprains, or its just not getting better you should see your doctor to get x-rays and examined, even if you had x-rays when you first hurt it.  Sometimes bone spurs or cartilage chips show up later on x-ray.  If that is normal you might need a magnetic resonance imaging (MRI) test which can look at the tendons, ligaments and cartilage. 

Surgery:

You might even need surgery.  Some teenagers feel like their ankle is unstable, and it is caused by an abnormal connection between two bones in the foot (called a coalition).  This is usually in people with a stiff flat foot, but not always.  By taking out this connection it might help with the feeling of instability or pain.  If the ligaments are stretched out they can be tightened.  A small camera can look into your ankle to see if your cartilage is intact, or if you have bone spurs.

Dr. Stewart played football, wrestled and ran track in high school.  At the United States Naval Academy he lettered in Sprint Football, and played rugby.  He coached football and wrestling while in medical school at Harvard.  Dr. Stewart trained in Orthopaedics at Naval Medical Center Portsmouth, and completed a fellowship in foot and ankle surgery in Tampa, Florida.  He is seeing patients at Virginia Institute for Sports Medicine and is stationed at Naval Medical Center Portsmouth.