Welcome to our new Ask the Doc feature. We will be posting regular updates from Dr. Sean Cook with questions pertaining to outdoor injuries and basic health and fitness. Up first is a classic trail injury: the ankle sprain. 

Hey Doc,

While skiing last winter I twisted my ankle. At a local ER I was diagnosed with a strained ankle.

What is the difference between an ankle strain and sprain?

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First, some basic anatomy: Ligaments are tissues that attach bone to bone whereas tendons are tissue connections between muscle and bone. The foot and ankle are connected by both. Ligamental stretching or tearing is called a sprain whereas the same injury on a tendon is a strain.

Over-lifting or excessive usage are two of the most common causes of strain and are not frequently associated with ankle injuries. Sudden rolling of the foot is the cause of most ankle sprains. The amount of damage to ankle ligaments is measured by three increasing grades. Minor amounts of swelling and pain are common to minimally damaged ligaments and are classified as grade I injuries. Inability to bear weight, especially if the affected ankle moves more freely compared to the non-affected ankle, may indicate may indicate a higher grade injury and the need for a formal medical evaluation.

Shoes with good ankle support that prevents ankle rolling are recommended whenever climbing or moving on uneven ground.

When Sean Cook, M.D., is not tempting fate kayaking the Chattooga River, you can find him practicing infectious disease in Eastern Georgia and South Carolina.