eMedicine Specialties > Sports Medicine > Foot and Ankle

Ankle Sprain: Follow-up

Author: Craig C Young, MD, Professor, Departments of Orthopedic Surgery and Community and Family Medicine, Medical Director of Sports Medicine, Sports Medicine Fellowship Director, Medical College of Wisconsin
Contributor Information and Disclosures

Updated: Apr 28, 2009

Follow-up

Return to Play

Athletes with ankle sprains may return to activities as limited by their symptoms. The physician may have to design a strict regimen (of activities) because many athletes have a tendency to ignore pain during activities. In general, individuals should start with in-line activities (eg, jogging) and then progress to forward-backward and side-to-side activities. Pivoting and cutting activities are added only when the athlete is minimally symptomatic with the previous activities.

Complications

Studies have shown that at least 40% of acute ankle sprains result in residual ankle symptoms at 6 months.42,43 At least 10-20% of acute ankle sprains result in residual ankle instability, pain, or other chronic symptoms.15,44,45

Prevention

Studies that document prevention of sprains are lacking in terms of warm-up activity and stretching. Athletes with a previous history of sprains should be encouraged to continue a strengthening and proprioceptive program on a continuing basis. Appropriate shoe wear should also be encouraged.

Prognosis

Athletes with mild ankle sprains usually recover relatively quickly. Athletes with moderate to severe lateral ankle sprains, medial ankle sprains, and high ankle sprains may take 4-8 weeks or longer to recover completely.

Education

Educate athletes about the importance of ankle strengthening and proprioceptive training to decrease the risk of future injury. Athletes who choose to use prophylactic lace-up type ankle braces must be educated about the importance of retightening the braces after warm-up.

Miscellaneous

Medicolegal Pitfalls

  • The major medical pitfall with regard to ankle sprains is to miss a clinically significant fracture. If a physician is following the Ottawa ankle rules and using appropriate clinical judgment, the chance of missing a clinically significant fracture is minimal.18
  • When a patient who has been diagnosed with an ankle sprain is not responding to appropriate treatment, a plain radiograph is mandatory to ensure that a tumor or fracture is not missed. Repeat plain radiographs, MRI, and/or orthopedic consultation may be warranted for an athlete who is not responding to the usual treatment guidelines in the expected time frame.
 


More on Ankle Sprain

Overview: Ankle Sprain
Differential Diagnoses & Workup: Ankle Sprain
Treatment & Medication: Ankle Sprain
Follow-up: Ankle Sprain
Multimedia: Ankle Sprain
References
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Further Reading

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Keywords

ankle sprain, sprained ankle, twisted ankle, ankle injury, rolled ankle, anterior talofibular ligament sprain, deltoid ligament sprain, high ankle sprain, lateral ankle sprain, medial ankle sprain, syndesmosis sprain, turned ankle

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Contributor Information and Disclosures

Author

Craig C Young, MD, Professor, Departments of Orthopedic Surgery and Community and Family Medicine, Medical Director of Sports Medicine, Sports Medicine Fellowship Director, Medical College of Wisconsin
Craig C Young, MD is a member of the following medical societies: American Academy of Family Physicians, American College of Sports Medicine, American Medical Society for Sports Medicine, Phi Beta Kappa, and Wilderness Medical Society
Disclosure: Nothing to disclose.

Medical Editor

David T Bernhardt, MD, Director of Adolescent and Sports Medicine Fellowship, Associate Professor, Department of Pediatrics, University of Wisconsin
David T Bernhardt, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Sports Medicine, and American Medical Society for Sports Medicine
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

CME Editor

Jon B Whitehurst, MD, Clinical Instructor of Surgery, University of Illinois College of Medicine; Partner and Executive Board Member, Rockford Orthopedic Associates; Orthopedic Chairman, Rockford Memorial Hospital
Jon B Whitehurst, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine, and Arthroscopy Association of North America
Disclosure: Nothing to disclose.

Chief Editor

Sherwin SW Ho, MD, Associate Professor, Department of Surgery, Section of Orthopedic Surgery and Rehabilitation Medicine, University of Chicago
Sherwin SW Ho, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine, and Arthroscopy Association of North America
Disclosure: Nothing to disclose.

 
 
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