Ankle Sprain

Medically Reviewed By William C. Lloyd III, MD, FACS

What is an ankle sprain?

An ankle sprain is a type of soft tissue injury. It occurs when a ligament in your ankle stretches more than it should. This overstretching causes ankle pain and problems with the joint. It is the result of some sort of sudden trauma. With severe ankle sprains, the ligament can stretch so far that it actually tears. The tear can be either partial or complete.

Ligaments are made of sturdy connective tissue. These elastic structures attach bones to other bones to hold the bones in the correct position and provide stability to the joint. Ligaments are different from tendons, which attach muscles to bones to allow movement. Normally, ligaments stretch with joint movement and return to their normal position. Most ankle sprains involve lateral ligaments—those on the outside of the ankle.

A sprained ankle is rarely an emergency and usually does not require surgery to heal. However, you should still seek prompt medical care after an ankle injury. Your doctor will need to verify that your ankle is not broken and that other joint structures are not damaged. Most people successfully recover when they stay dedicated to the treatment plan. Without proper treatment and healing, you risk developing chronic problems with the ligament. This can result in repeated sprains and ankle instability.

What are the symptoms of an ankle sprain?

The main sprained ankle symptoms are pain and swelling. The degree of these two symptoms will depend on the grade of the sprain. With a minor sprain, the pain and swelling will be mild. However, severe sprains with tearing can result in intense pain with significant swelling. Other common symptoms of an ankle sprain include:

  • Bruising

  • Hearing a popping sound during the injury

  • Inability to stand or bear weight on the injured leg

  • Instability of the joint, which the doctor may be able to feel when he pushes or pulls on the ankle

  • Tenderness to the touch

Always see a doctor after an ankle injury. You need an accurate diagnosis to make sure the rest of your joint is healthy. Seeking early medical care offers the best chance of successfully recovering from a sprained ankle. If you do not recall injuring your ankle, see your doctor if ankle pain persists for more than a couple of weeks.

What causes a sprained ankle?

A sprained ankle is the result of some type of injury or trauma. This can include rolling, twisting or turning your ankle. You can also cause an ankle sprain if you plant your foot unevenly or forcefully. The more force involved in the injury, the more damage the ligaments are likely to sustain. Severe trauma can also damage bones and other joint structures.

What are the risk factors for an ankle sprain?

Playing sports and participating in rigorous physical activities is a common risk factor for ankle sprains. This is especially true for sports and activities involving jumping. Landing incorrectly can result in the injuries that cause an ankle sprain. In addition, some people have a predisposition for ankle sprains. This includes people with ankles that naturally turn inward and those who have already sprained an ankle.

Reducing your risk of ankle sprain

You may be able to lower your risk of a sprained ankle by:

  • Balancing strength training, cardiovascular exercise, and flexibility stretches

  • Cross-training by alternating high-impact and low-impact activities

  • Strengthening the muscles in you lower legs and feet

  • Wearing the correct footwear for your sport or activity with the proper fit

  • Wrapping your ankle with a compression bandage during sports and activities

Work with your doctor or athletic trainer to find the right exercises and precautions for you.

How is an ankle sprain treated?

The goal of sprained ankle treatment is to reduce pain and swelling, and allow the joint heal. In most cases, how to heal a sprained ankle means using over-the-counter pain relievers and the RICE protocol:

  • Rest by keeping weight off your ankle

  • Ice by applying an icepack to the ankle for about 20 minutes several times a day. Don’t apply an icepack directly to the skin. Instead, wrap it in a thin towel or covering.

  • Compression by using an elastic wrap to support your ankle

  • Elevation by propping your ankle on some pillows to position it higher than your heart. Spend as much time as you can in this reclined position during the first 48 hours after injury.

How to treat a sprained ankle depends on the severity of the sprain. You may need to wear a splint or walking boot or use crutches while your ankle heals. Minor ankle sprains should heal within a few days. With higher-grade sprains, recovery can take several weeks. You may also need physical therapy to help you recover and return to activities. In rare cases, severe ankle sprains may require surgery.

What are the potential complications of an ankle sprain?

In most cases, people successfully recover from an ankle sprain without any chronic problems. However, this relies on your dedication to your treatment and rehabilitation plan. Not completing rehabilitation is the most common cause of chronic complications after a sprained ankle. This leaves the ligament and surrounding muscles weak, which increases the risk of continued ankle sprains.

Another cause of continued ankle sprains is abnormal proprioception. This means your brain has trouble correctly sensing a body part’s position. In this case, it’s the ankle and foot. This problem can be due to muscle imbalances and weaknesses from incomplete healing and rehabilitation.

See your doctor if you still have pain, instability, or a sense of the ankle giving way 4 to 6 weeks following your injury.

Was this helpful?
  1. Ankle Sprain. American Orthopaedic Foot & Ankle Society.
  2. Cross Training. American Academy of Orthopaedic Surgeons.
  3. Questions and Answers About Sprains and Strains. National Institute of Arthritis and Musculoskeletal and Skin Diseases.
  4. Sprained Ankle. American Academy of Orthopaedic Surgeons.
  5. Sprains, Strains, and Other Soft Tissue Injuries. American Academy of Orthopaedic Surgeons. 
Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Aug 21
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