Sprained Ankle

The ankle joint is held in place by strong, fibrous tissue called ligaments. Ligaments connect the bones and help support your ankle. 

A sprained ankle is an injury to one or more ligaments in your ankle. When you twist or roll your ankle, the ligaments can stretch too much or even tear. 

Sometimes called a twisted ankle, this injury can be mild to severe. The injury is often graded. 

• Grade 1 (Mild): Slight stretching, mild swelling and little pain. You can still put weight on the ankle.
• Grade 2 (Moderate): A partial tear with more swelling, bruising and difficulty walking on the ankle.
• Grade 3 (Severe): A full tear with a lot of swelling, intense pain and trouble standing or walking on the ankle.

Causes of a sprained ankle

Sprains can happen in many different ways. Common reasons include:

• Walking or running on uneven ground
• Stepping off a curb suddenly
• Landing wrong after a jump
• Injury playing sports like basketball, soccer, football, tennis or volleyball
• Wearing high heels, wedges or unstable shoes
• Tripping, falling or twisting suddenly

Even minor activities can lead to a sprain. Older adults and people with weak ankles are at higher risk. 

There are three main types of ankle sprains. Each type depends on which ligaments are hurt and how your ankle twists.

• Inversion ankle sprain: This is the most common type of ankle sprain. It happens when your foot rolls inward, stretching or tearing the ligaments on the outside of your ankle. The ligament most often affected is called the anterior talofibular ligament (ATFL). 
• Eversion ankle sprain: This sprain happens when your foot turns outward. This puts stress on the ligaments on the inside of your ankle. The deltoid ligament, a strong band of tissue on the inside of the ankle, can get stretched or torn. 
• High ankle sprain: This sprain affects the ligaments above the ankle joint, where the two long bones in the lower leg (the tibia and fibula) meet. This type of sprain is common in sports like football, rugby and soccer that involve a lot of contact. It usually takes longer to heal than other sprains.

Symptoms can show up right away or within a few hours. Look out for: 

• Pain, especially when you put weight on the ankle 
• Swelling around the joint 
• Bruising or discoloration 
• Stiffness or difficulty moving the ankle 
• Feeling like the ankle is about to give out or feels unstable 
• A popping or tearing feeling at the time of injury

Severe sprains may make walking impossible. Mild sprains might only cause minor discomfort.  

Most ankle sprains can be treated at home, but some injuries need medical care. See your health care provider or go to an urgent care if you notice:

• Severe pain or swelling
• You can't move or put weight on your ankle
• Numbness or tingling in your foot develops
• Bones that look out of place
• Pain that doesn’t go away after a few days of rest 

Your health care provider will diagnose your sprained ankle after a physical exam. They will check:

• Swelling and bruising
• Range of motion
• Tenderness around the ankle
• Ability to bear weight

Imaging tests may include:

• X-rays: To rule out broken bones
• MRI or CT scans: For severe injuries or ligament tears 

Treating a sprain depends on its severity. Most people recover with care at home. 

Mild to moderate sprains

Follow the R.I.C.E. method for mild to moderate sprains:

• Rest: Avoid activities that hurt. Use crutches if you need them.
• Ice: Put ice packs on the ankle for 15-20 minutes every two to three hours.
• Compression: Wrap the ankle with an elastic bandage to help reduce swelling.
• Elevation: Keep your ankle raised above your heart to help reduce swelling.

Pain medicines like acetaminophen or ibuprofen can also help.

Moderate to severe sprains 

Additional care may be required for moderate to severe sprains:

• A walking boot, brace or splint for support
• Physical therapy to restore strength and flexibility
• Evaluation with an orthopedic or sports medicine specialist

Do ankle sprains require surgery?

Most ankle sprains do not need surgery. However, if you have serious ligament damage or keep spraining your ankle, your provider may recommend surgery. 

Recovery depends on the severity of the sprain: 

• Mild sprains usually heal in one to three weeks. 
• Moderate sprains may take four to six weeks. 
• Severe sprains can take eight to 12 weeks or more.

Even after the pain goes away, the ankle might still feel weak. Doing physical therapy can help prevent future injuries. Exercises may include gentle stretching, strength building and balance and stability exercises. 

Preventing future sprains is possible. Try these tips: 

• Wear supportive shoes and avoid unstable heels 
• Warm up before exercise 
• Strengthen ankle muscles with simple exercises 
• Be cautious on uneven surfaces 
• Use a brace if you have a history of sprains

Learn other ways to support your ankles. 

Our orthopedic and sports medicine experts can help you. They are known for their specialized care and want to help you recover. We create detailed treatment plans just for you, using the latest techniques and therapies, to help you do what you love again.

Get expert care and a personalized treatment plan. Make an appointment today.