A ligament is a thick fibrous band of tissue that connects two bones together in a joint. Ligaments add stability to a joint and keep it intact. A sprain is the stretching or tearing of a ligament. According to the American Academy of Orthopedic Surgeons (AAOS), 25,000 people sprain an ankle each day. An ankle sprains when the foot rolls, twists or turns outside its normal range. A torn ligament is first treated conservatively, but may require surgery depending on the severity of the tear.
Grade 1 Sprain
A grade 1 sprain involves slight stretching and small, microscopic tears in the ligament fibers. This type of sprain most likely occurs if a patient rolls his ankle on an uneven surface or during light physical activity. Pain and tenderness around the damaged ligament is mild and the patient can generally still walk on the ankle without difficulty. The AAOS recommends therapeutic exercise to help strengthen the muscles around the ankle and speed the healing process. Specifically, a physical therapist may teach the patient isometric exercises--exercises that don't involve active movement of the ankle. For example, standing on the toes for 10 seconds is considered an isometric exercise. In addition, stretching exercises should be performed as tolerated.
Grade 2 Sprain
A grade 2 sprain is more involves more extensive injury to the ankle ligament. This tear involved complete tears of individual ligament fibers, but not a tear of the entire ligament. A patient may notice moderate tenderness and swelling, a decrease in range of motion and an inability to walk on the ankle without assistance, states the AAOS. A doctor will likely provide an air splint, which will provide stability to the ankle. More intensive physical therapy may be recommended that includes more extensive stretching and strengthening exercises.
Grade 3 Sprain
Grade 3 sprains involve the complete tear of the ankle ligament. According to the AAOS, a patient may notice significant swelling and tenderness. The patient will probably have extreme difficulty in walking on the damaged ankle because of pain and instability. First, the ankle is immobilized in a splint or cast to allow the swelling and inflammation in the ankle time to subside. Then, the patient will be placed in intense physical therapy to strengthen the ankle and improve its range of motion. If little or no progress is made in physical therapy, surgery may be recommended to repair the torn ligament.
