What is an ankle sprain?

Ankle sprains are ordered into grades by how severe they are.

  • Grade I sprains are the mildest. The ligaments have been stretched and you may feel some soreness and swelling. These tend heal on their own within a few days to a couple of weeks. Grade 1 sprains are usually treated using the rest, ice, compression, and elevating the leg.
  • Grade 2 sprains are when the ligaments tear a little. Your ankle joint may feel wobbly or loose. These sprains cause more pain and swelling, and sometimes bruising. You may need to wear a splint or cast.
  • Grade 3 sprains are when the ligament tears completely. Your ankle joint will be very painful and unstable and you may not be able to put any weight on it. A Grade 3 sprain can lead to permanent ankle disability if not treated. You should see a doctor as soon as possible. Surgery is only usually indicated if conservative measures fail for several months.

A sprain sometimes happens with other ankle injuries, such as a broken bone. If the sprain is very painful or you can’t put weight on it, have it checked by a healthcare provider.

Symptoms

Most of the time, you will begin to feel the symptoms of an ankle sprain right after it is injured. Symptoms of an ankle sprain almost always include:

  • Swelling
  • Tenderness
  • Mild to moderate pain, especially when trying to move the joint
  • Tenderness when touched
  • Ankle instability

In some cases, you may not be able to put weight on your ankle right after it is sprained.


If the sprain is more serious, you may feel a tearing sensation when the ankle is injured and hear a pop or snap. You may also notice:

  • Bruising
  • Inability to move the joint (usually due to swelling)
  • Extreme pain
  • Inability to put weight on the foot

As a general rule, the more pain and swelling you have with your sprain, the more serious it is, and the longer it may take to heal. If you notice the symptoms of a more severe sprain, you should see your healthcare provider for treatment.

Causes

Most of the time, an ankle sprain is caused by an over-extension in the ankle joint, such as twisting too much, or rolling more than the joint is supposed to normally move. In most sprains, the ankle rolls outward and the foot turns inward, over-stretching the ligaments on the outside of the ankle. This can be caused by:

  • Tripping or falling in a way that twists your ankle
  • Landing wrong after jumping or pivoting
  • Someone else landing on you, as can happen during a sports activity

Some people may have weak ankles or other diseases that run in the family and make them more prone to ankle sprains. Also, having one ankle sprain makes it more likely to get more ankle sprains in the future as they can make the ankle weaker.

When to See a Doctor

  • Walking is very painful or you can’t put weight on it
  • The pain doesn’t get better after resting and icing it
  • Your bruising, swelling, or pain is getting worse
  • Your ankle continues to feel weak or unstable
  • You have signs of an infection, such as redness, warmth, and tenderness in the injured area, or a fever over 100-degrees Fahrenheit

Diagnosis & Tests

Your doctor may perform a physical exam to help diagnose an ankle sprain. During the exam, your doctor will check your ankle and foot, as well as your lower leg and even your knee to make sure there are no other injuries.

Your doctor will also ask what caused the injury to help find out whether you received other injuries (such as an ankle fracture). Your doctor may also take x-rays to make sure the ankle is not broken or fractured, and confirm that the only injury is a sprain.

Treatments & Prevention

Treatments

Mild ankle sprains are often treated at home using the RICE method. RICE stands for:

  • Rest: Avoid putting weight on the injured ankle, and avoid participating in normal activities until your ankle gets better.
  • Ice: Use an ice pack (you can also use a bag of frozen vegetables if you do not have an ice pack) for 15-20 minutes, three times a day.
  • Compression: You can use a compression bandage, compression sock, or compression brace to help put pressure on the ankle and reduce swelling.
  • Elevation: To keep swelling down, elevate (raise) your foot above the level of your heart. You can do this by lying down on a couch or floor and placing pillows under your foot and knee until your ankle is higher than your chest.

You can also try to reduce swelling and relieve pain using over-the-counter pain medications such as naproxen sodium (Aleve) or ibuprofen (Advil).

If your symptoms last more than a week without getting better, or if they seem to be getting worse and are accompanied by a fever, make an appointment to see your doctor as soon as possible.

More severe sprains should be treated by a healthcare provider. Treatment may include:

  • Using a splint or cast to keep the ankle from moving.
  • Physical therapy to help regain the full range of motion.
  • In rare cases, surgery may be needed to repair the ligament.

It’s important to rest your ankle until it’s fully recovered. As a rule, most of the time it is safe to begin them once your ankle can bear weight again without pain or discomfort. But if you return to activity too quickly after your injury, you run the risk of re-injuring it or worsening your injury.

If you have sprained your ankle, regardless of the severity, you may want to look into physical therapy to help teach you how to strengthen the muscles around your ankle and help you prevent re-injury. Talk to your doctor about when it is safe to begin ankle-strengthening exercises after your injury.