What’s actually happening when you sprain your ankle?
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In your joints, where one bone connects to another, the bones themselves don’t link. They can’t – they’d be too rigid and wouldn’t be able to move around freely.
Instead, the bones come close together, and a bunch of little slightly-stretchy flexible fibers called *ligaments* actually form the connection between them. (Compare *tendons*, which connect bone to *muscle*.) A sprain is when the ligaments are damaged, usually by bending a joint too far or in an unusual way.
A ligament, which is a piece of tough connective tissue that holds the bones of your feet together, is partially or totally ripped in half like a paper towel, causing internal bleeding that oozes up through your skin and shows up as a bruise.
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In your ankle there are a bunch of bones that connect your leg to your foot. These ankle bones are kept together by a bunch of ligaments. Ligaments are like a thick rubber band, a little bit stretchy but have limits. When you sprain your ankle, you over stretch the ligaments in your ankle.
Ligaments are tough, fibrous tissues which hold bones together. They also restrict the motion of joints to a healthy amount (you wouldn’t want your joints to move too much.)
Ligaments often have fiber bundles that are arranged in orderly parallel lines like you might hold a handful of uncooked spaghetti. This makes them very strong under tension (like a rope).
When a joint moves too far or in a direction that it should not, the ligament is stretched. The fiber bundles can pull away from each other on a microscopic level. Inflammatory cells can then come to the ligament to start the process of repairing damage. In the meantime, they will also bring fluid and swelling and make the ligament stiff and tender (painful).
A picture is worth 100% words.
[Here](https://upload.orthobullets.com/topic/7005/images/awesome_ankle.jpg) is a picture of an ankle without skin or (extrinsic) muscles. Numbers 8 and 9 are common sprains, especially if your roll your ankle inward (inversion).
[Here](https://image.slidesharecdn.com/tendonsligaments-110825102839-phpapp01/85/tendons-ligaments-10-320.jpg?cb=1666010019) is a picture of microscopic structure of a ligament.
Bones don’t link together, tissue connects them. Ankle sprains are stretching them too far so now they are separated til they rest long enough to tighten back up.
I’d like to ask a question off the back of this; so I (29F) sprained my ankle 3 and a half weeks ago, and it still hurts to walk on, especially stairs or slopes etc. I’ve sprained this ankle several times over the years. Therefore my question is what could be the way forward for my ankle health? Should I look into surgical options? I don’t want to spend 1-2 months every year for the rest of my life “resting my ankle”!
(I do have a Dr appointment in a few weeks to also discuss my options!)
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