Ankle Sprain: Symptoms and Early Management

An ankle sprain of the anterior talofibular ligament (ATFL) is a common injury that occurs when the ligament on the front-outer side of the ankle is stretched or torn. The ATFL is one of the primary ligaments that helps stabilise the ankle joint, and it is often injured during activities that involve rapid changes in direction or pivoting.

Common symptoms of an ATFL ankle sprain may include:

1. Pain on the outer side of the ankle

2. A popping or tearing sensation at the time of injury

3. Swelling and bruising around the ankle

4. Limited range of motion and stiffness in the ankle

5. Difficulty bearing weight on the affected ankle

The severity of an ATFL ankle sprain tends to be graded i - iii, depending on the extent of the damage. In some cases, i. may only involve pain & micro-tears in the ligament but still structurally sound, ii. is more significant, more painful and involves more swelling with some bruising, iii. may involve a complete rupture or tear of the ligament.

Early management for an ATFL ankle sprain typically involves the POLICE:

P - Protection: Protect the injured area from further damage by immobilising or limiting movement as needed. This may involve using a brace, splint, or crutches for a short period of time while the initial healing takes place. 

O L  - Optimal Loading: Gradually introduce controlled, gentle movement or loading to the injured area to promote tissue healing and prevent stiffness or weakness. This may involve doing specific exercises or stretches recommended by a healthcare professional.

I - Ice: Apply ice to the injured area for 15-20 minutes at a time, several times per day, to help reduce pain. Making sure not to cause yourself an ice burn by doing it for too long or too regularly.

C - Compression: Use compression, such as Compression Socks, Normatec, Aquilo, to help reduce swelling and assist the body’s natural venous return system in removal of inflammatory products 

E - Elevation: Elevate the injured area above the level of the heart whenever possible. This uses gravity to promote and facilitate the venous return process while you’re moving around less and encourage the swelling to flow towards our lymph nodes which help to remove it.

This is often used in the initial stages of injury recovery, typically the first few days to weeks. Most people recover fully from an ATFL sprain and return to normal activities within a few weeks to several months. In more severe cases, a healthcare professional may recommend immobilisation with a special boot. Surgery is rarely necessary for an ATFL ankle sprain unless the ligament tear is severe and usually reserved for high level athletes where the demand on the structure after recovery will be significant. After the initial acute phase comes rehabilitation and exercises to regain strength and function. 

As Always, it's important to follow a healthcare professional's recommendations for rehabilitation and to avoid returning to activities too quickly, which could lead to prolonged recovery.