Ankle sprains are very common, especially in youth athletes. They occur when the forces from the injury (often a twist) onto the patient are too great for the ligaments to resist and as a result, they tear. Lateral (outside of the ankle) sprains are by far the most common. This occurs often when we roll our ankle.
There are three grades of lateral ankle sprains:
Grade I: This is the most minor of the sprains and essentially is a stretching or even partial tearing of one of the ligaments on the outside of the ankle.
Grade II: This is a tearing of one ligament and a tear of another ligament. Most of the time, this injury is also treated with exercise and pain relieving modalities (treatments).
Grade III: This is a full tear of at least two and possibly all three ligaments on the outside of the ankle. In all cases, rehabilitation and physical therapy is critical to maximizing the recovery after the surgery and returning the patient to their full function from before the injury!
The most common ligament in the ankle to tear is the anterior talo-fibular ligament (ATFL), but there are two other ligaments on the outside of the ankle: the posterior talo-fibular ligament (PTFL), and the calcaneal fibular ligament (CFL). The most important thing to do after an ankle sprain is to regain proprioception (the ability for the body to know when it is in space). This is done through a systematic advancement of balance exercises. Sometimes patients treat the sprain with just rest and an ankle brace when they return to activity. This treatment alone with no other therapy will likely increase the chance of spraining the ankle again.