Sprained Ankle

A sprained ankle occurs when the ligaments supporting your ankle joint are stretched or torn, often due to twisting, rolling, or sudden impact. Symptoms typically include pain, swelling, bruising, and difficulty walking. While mild sprains may heal with self-care, more severe injuries may require a medical evaluation, physiotherapy, or supportive devices. Understanding the causes, treatments, and prevention strategies can help ensure a smooth recovery and reduce your risk of future sprains.

What is a sprained ankle?

A sprained ankle occurs when the ligaments that support your ankle joint are stretched or torn beyond their normal range. This often happens due to a fall, sudden twist, or rolling of your ankle, causing pain, swelling, and difficulty walking. The severity of a sprain can range from mild overstretching to complete ligament tears, which affect your recovery time and treatment options.  

Symptoms of sprained ankles

The severity of a sprained ankle determines the symptoms, but common signs include:

• Pain - especially when bearing weight on your affected foot.
• Swelling - around your injured area.
• Bruising - discoloration from ligament damage.
• Restricted movement - difficulty moving your ankle normally.
• Instability - feeling wobbly or unstable when standing.
• Tenderness - pain when touching your ankle.
• Popping sensation - you may feel or hear a pop at the moment of injury.

What causes a sprained ankle? 

A sprained ankle happens when the ligaments supporting your joint are stretched or torn due to excessive force. Common causes include:

• Twisting or rolling your ankle - sudden movements or missteps can overstretch your ligaments.  
• Falls or trips - uneven surfaces or losing balance can lead to an ankle sprain.  
• Landing awkwardly - jumping or pivoting incorrectly increases your risk.  
• Sports injuries - activities like basketball, football, soccer, and tennis involve quick movements that can strain your ankle.  
• Impact injuries - another person stepping on your foot or a direct blow can cause ligament damage.  

Types of ankle sprains

Ankle sprains are classified into three grades based on the extent of ligament damage:

Grade 1 (Mild)

The ligament is slightly stretched or has a small tear, causing minor swelling and tenderness. Most people can still put weight on their foot.

Grade 2 (Moderate)

The ligament is partially torn, leading to noticeable swelling, bruising, and pain. Weight-bearing may be difficult.

Grade 3 (Severe)

The ligament is completely torn, resulting in significant swelling, severe pain, and instability. Walking is often very painful or impossible without support.

When to see a doctor about a sprained ankle

Not all ankle sprains require medical care, but certain red flags indicate when to worry about a sprained ankle and that you may need a professional evaluation. These include:

• Severe pain or swelling that doesn’t improve with rest, ice, compression, and elevation (RICE).
• Inability to bear weight or walk without significant discomfort.
• Visible deformity or unusual movement in your ankle.
• Numbness or tingling, which could indicate nerve involvement.
• Persistent stiffness or weakness lasting beyond a few days.
• No signs of improvement after home treatment.

If your ankle feels unstable, keeps giving out, or symptoms worsen, consult a doctor or physiotherapist to rule out fractures or severe ligament damage. 

Sprained ankle treatment

Sprained ankle treatment depends on the severity of the injury. PRICE therapy -protection, rest, ice, compression, and elevation - is often the first step to reduce swelling and pain. Physiotherapy helps restore strength and mobility, while braces, supports, or crutches can aid recovery. In severe cases, surgery may be needed to repair torn ligaments.

How to care for an ankle sprain at home

For most ankle sprains, it’s best to follow the PRICE method for the first 24 to 48 hours to reduce swelling and support healing:  

• Protection - use crutches, a splint, or a brace to limit movement and prevent further injury.  
• Rest - avoid activities that put stress on your ankle, such as running, jumping, or exercising.  
• Ice - apply an ice pack wrapped in a towel for 20-minute intervals to reduce swelling.  
• Compression - wrap your ankle gently with an elastic bandage to minimise swelling.  
• Elevation - keep your ankle raised above heart level using pillows while sitting or lying down. 

If pain and swelling are severe, or if walking is difficult, seek medical attention to rule out more serious injuries. 

Pain relief and medication

Most sprained ankles can be managed with over-the-counter pain relievers like ibuprofen, naproxen, or acetaminophen, which help reduce pain and inflammation. Topical gels containing ibuprofen can provide localised relief when applied directly to your skin.  
If over-the-counter options aren’t effective, a doctor may prescribe stronger pain medications to help manage discomfort. Always follow dosage instructions and consult a healthcare provider if symptoms persist.

Physiotherapy

Once swelling and pain subside, physiotherapy helps restore your range of motion, strength, flexibility, and stability. A physiotherapist will guide progressive exercises tailored to your recovery needs.

• Balance and stability training - retrains your ankle muscles to support the joint and prevent future sprains. Exercises may include single-leg stands or controlled movements on unstable surfaces.  
• Strengthening exercises - target your calf, foot, and ankle muscles to improve support and reduce reinjury risk.  
• Mobility work - helps regain normal movement patterns, ensuring your ankle functions properly. 

Devices and supports

Depending on the severity of your sprain, you may need supportive devices to aid your healing and prevent further injury, including:  

• Crutches - help reduce weight-bearing on your injured ankle, especially in severe cases.  
• Elastic bandages or compression sleeves - provide gentle support and help control swelling.  
• Ankle braces - stabilise your joint and limit excessive movement while allowing mobility.  
• Walking boots or air casts - for more serious sprains to immobilise your ankle and promote healing.  

Surgery 

While most ankle sprains heal with conservative treatments, surgery may be recommended in rare cases where your injury doesn’t improve or your ankle remains unstable despite physiotherapy and rehabilitation. Surgical options include:

• Ligament repair - fixing a damaged ligament that won’t heal on its own.  
• Ligament reconstruction - using tissue from a nearby ligament or tendon to restore stability.  
• Arthroscopy - a minimally invasive procedure to remove damaged tissue or bone fragments.  

If surgery is required, recovery typically involves immobilisation, physiotherapy, and gradual return to activity. You can learn more about podiatric surgery or explore additional details on ankle disorders and surgery.

Sprained ankle recovery time

Your sprained ankle recovery time depends on the severity of your injury: 

• Mild sprains (Grade 1) - typically heal within 2 to 4 weeks with proper care.  
• Moderate sprains (Grade 2) - may take 6 to 12 weeks to fully recover.  
• Severe sprains (Grade 3) - can require several months of rehabilitation, especially if ligament damage is extensive.  

Most sprains improve with PRICE therapy, physiotherapy, and the gradual return to activity. Severe cases may need medical intervention for optimal recovery. 

The difference between a sprained ankle and a broken (fractured) ankle

You may wonder if you have a sprained or broken ankle. There are several differences when considering a sprained ankle vs broken ankle. An ankle sprain occurs when the ligaments supporting your joint are stretched or torn, while an ankle fracture involves a break in one or more of your ankle bones. 

Both sprains and fractures cause pain, swelling, bruising, and tenderness, but the key differences lie in the location and severity of discomfort. Sprain-related pain usually affects the soft tissue around your ankle, and some movement may still be possible, whereas fractures cause pain directly over your bone, often accompanied by visible deformity or numbness. 

Healing time also varies, with mild sprains typically recovering in 2 to 4 weeks, while severe sprains may take 6 to 12 weeks. Fractures generally require at least 6 weeks to heal, though recovery may take longer depending on the severity and the need for surgery.

How is a sprained ankle diagnosed?

A doctor will assess a sprained ankle through a physical examination, checking for swelling, bruising, tenderness, and range of motion. They may gently move your ankle to determine which ligaments are affected.  
If your injury appears severe or if a fracture is suspected, imaging tests such as X-rays, MRIs, or ultrasounds may be used to confirm the diagnosis and rule out broken bones.  

Risk factors for ankle sprains

Certain factors can increase your likelihood of spraining an ankle: 

• Sports participation - activities like basketball, soccer, tennis, and trail running involve quick movements that can strain your ankle.  
• Uneven surfaces - walking or running on unstable ground raises your risk of rolling your ankle.  
• Previous ankle injury - a history of sprains or other ankle injuries makes future sprains more likely.  
• Weak muscles or poor conditioning - lack of strength or flexibility in your ankle can increase your vulnerability.  
• Ligament laxity - naturally loose joints may make your ankle more prone to sprains.  
• Improper footwear - wearing shoes that don’t provide adequate support, such as high heels, can increase your risk.  
• Fatigue - tired muscles and ligaments are more susceptible to injury, especially towards the end of intense activity.  
• Excess weight - carrying extra weight puts more strain on your ankle, increasing your likelihood of a sprain.  

Ankle sprain complications

Ignoring or improperly treating a sprained ankle can lead to long-term issues, including:

• Chronic pain - persistent discomfort that may interfere with daily activities.
  Ankle instability - weakness in your joint that increases your risk of future sprains.
• Reduced mobility - stiffness or difficulty moving your ankle normally.
• Post-traumatic arthritis - damage to your joint can lead to early-onset arthritis.
• Delayed healing - without proper care, recovery may take longer or remain incomplete.
  Seeking early treatment can help prevent these complications and support your full recovery.

How to prevent a sprained ankle

Taking proactive steps can help reduce the risk of ankle sprains:  

• Warm up before activity - stretch and mobilise your ankles before exercising or playing sports.  
• Strengthen your ankles - build muscle support with exercises that target your calf and ankle.  
• Improve balance and stability - training exercises like single-leg stands can enhance your coordination.  
• Wear proper footwear - choose well-fitted, supportive shoes designed for your activity.  
• Use ankle braces or tape - provides extra stability, especially if you have a history of sprains.  
• Be cautious on uneven surfaces - watch for unstable ground when walking or running.  
• Avoid excessive fatigue - tired muscles are more prone to injury.  
• Maintain flexibility - stretch regularly to keep your ankle ligaments and muscles mobile.