A sprained ankle happens when you hurt one or more of the ligaments around your ankle joint. Your ankle may be painful and swollen, and you may find it hard to move your foot.
An ankle sprain can be very painful, but the good news is that most heal well without any issues. With simple self-care advice, most people get better after a few weeks and return to their normal activities in a few months.
What Is a Sprained Ankle?
An ankle sprain occurs when the ankle twists unnaturally, distressing the joint’s ligaments and causing pain and swelling.
There are two main ligaments in the ankle, the calcaneofibular ligament and the anterior talofibular ligament. These two ligaments hold the ankle bones in position and their job is to protect the ankle and foot from twisting or turning.
A ligament is like a rubber band, stretching within its limits and returning to its original shape. A sprain or strain will occur when the ligament it’s stretched too much. A severe sprain can cause tearing of the ligament’s elastic fibers, similar to when a rubber band is stretched beyond its limit.
Common Causes of Ankle Sprains
Sprained ankles can happen almost anywhere and are surprisingly common. The movements that cause such injuries include rotation or rolling of your ankle in either direction and can happen while doing any of the following activities:
- Stepping off a curb.
- Walking or running.
- Tripping over something.
- Landing at an angle after jumping.
- Rolling or twisting to the side with a high-heeled shoe.
How Do I Know if My Ankle Is Sprained?
Ankle sprains tend to produce pain, swelling, bruising, and tenderness around the ankle joint, as well as making it difficult or impossible to bear weight on the affected leg. Symptoms can be similar or identical to a broken ankle, so it’s essential to see a doctor for a proper diagnosis.
Specific symptoms of a sprained ankle may include:
- Pain at one or both sides of the ankle.
- Swelling, often extensive, throughout the ankle joint.
- Tenderness on the skin around your ankle.
- An inability to bear weight or move your ankle.
- Redness or bruising of the skin around the ankle.
- A sound like a pop or snap may occur during an extreme sprain.
If you experience any of these symptoms immediately or soon after twisting or rolling your ankle, chances are that you have an ankle sprain.
Types & Severity of Sprained Ankle
Ankle sprains come in two distinct types, and medical professionals group them into three levels or grades. Types are related to the injury’s location and the ligaments affected. Grades related to the injury’s severity.
Low or Common Ankle Sprains
A common ankle sprain is when ligaments on the outside of the ankle or the anterior talofibular ligament (the one that stabilized the ankle) become injured. This common ankle sprain usually requires a relatively short rehabilitation time.
High Ankle Sprains
The high ankle ligaments are called syndesmosis. A high ankle sprain is when the syndesmosis is torn or damaged, usually from a sudden twisting, turning, or cutting motion. It could happen when a person is running or jumping. The syndesmosis ligaments are located above the ankle and connect the tibia to the fibula.
This is a common injury for athletes playing high-impact running sports like football, rugby, soccer, or basketball, but it is far less common than a common ankle sprain.
Grade 1 Sprain
A Grade 1 sprain involves light stretching and some damage to the fibers of a ligament. There is minimal tenderness and swelling and an ongoing ability to move the joint. Walking may be painful, though.
Grade 2 Sprain
A Grade 2 ankle sprain involves partially tearing the ligament or ligaments. A person with a Grade 2 sprain will experience abnormal looseness and movement when the joint is moved. It also produces moderate swelling and tenderness, a decreased range of motion, and possible instability. Walking with a Grade 2 ankle sprain is painful, but not impossible.
Grade 3 Sprain
A Grade 3 ankle sprain produces a complete tear of the ligament. If the ankle joint is pulled or pushed, severe looseness and movement of the joint become apparent. A Grade 3 sprain produces significant swelling, pain, and significant instability. Walking on a Grade 3 ankle sprain is impossible.
Sprained Ankle Treatment
Treatment varies depending on the type and grade of the sprain. If you suspect that you have an ankle sprain, see a doctor as soon as possible to ensure you don’t have a broken ankle because symptoms are often similar.
You can take some simple measures at home to treat the ankle to see if it improves. You can notably control swelling and pain using medication and the RICE method, which employs rest, ice, compression, and elevation.
Inflammation Control and Pain Relief Using Medication
A medication such as Ibuprofen will help with the initial discomfort of your ankle sprain. Many over-the-counter (OTC) medications are used not only for pain relief but also to reduce inflammation. Your doctor may recommend one of the following:
- Ibuprofen (Advil and Motrin)
- Naproxen (Aleve)
- Tylenol (Acetaminophen)
- Generic Aspirin
- Topical Creams (Many of the analgesic active ingredients can be found in cream form. If your ankle is not cast, direct topical cream placement on the injury can offer immediate pain relief.)
RICE
The acronym RICE stands for Rest, Ice, Compression, and Elevation. RICE is a time-honored way of healing several lower leg and foot injuries, including a sprained ankle.
Rest
Sometimes, the best way to rest your leg is to stop standing and walking on it. Your doctor will tell you how long you need to stay off your ankle, and it will depend on the type and severity of your injury. The time range can be from several weeks to several months.
Occasionally, just a few days of keeping weight off your ankle are all that’s needed to start feeling better. There are several mobility devices to choose from to help you stay off your injured foot while allowing it to heal.
Ice
Placing ice on the most painful area of the ankle while you rest will also be helpful. It can be done throughout the day to help with swelling and pain relief. You can ice for up to 20 minutes, up to four times a day, but do not place the ice directly on your skin. Use a thin cloth between the ice and your skin to protect from ice burn. If your skin becomes red or numb, remove the ice pack and ice for shorter periods of time.
Compression
A compression wrap can help control swelling while immobilizing and supporting your injured ankle. Applying a compression wrap, elastic bandage, or Ace bandage is fairly easy and can be done at home. For a quick reference on the correct method, here’s a video: “How to Wrap an Ankle With an Ace Bandage.” For additional support, you can wear a protective brace or splint. Both are relatively inexpensive and can be found at most drugstores.
Elevation
Whenever possible, elevate your sprained ankle to help prevent or limit swelling. Elevating the injured ankle above your heart keeps fluid and blood from pooling in the ankle due to gravity. The best way to elevate your sprained ankle in bed is to place several pillows under your leg, one under your knee, and one under the ankle. You can also elevate your ankle in a recliner, but place several pillows under it, so it’s higher than your heart. Keep your ankle elevated for 48 hours, and don’t walk on it.
If your sprain improves with the RICE treatment, seeing a doctor may not be necessary. However, if you experience any of the following symptoms, you should see a doctor:
- The pain is difficult to bear.
- The swelling doesn’t go down with the RICE treatment.
- You experience significant instability in the joint.
Be cautious with self-diagnosed ankle sprains because they can often be mistaken for a broken bone. If your ankle isn’t improving, a doctor will order X-rays to check for broken bones in the foot or ankle. The injured ligament may feel tender, and the doctor may need to move your ankle into a variety of positions to determine which ligament has been hurt or torn.
How Long Should It Take for an Ankle Sprain To Heal?
The healing process for a sprained ankle takes four to six weeks. Surgery is rarely required, which is great news!
Even a complete ligament tear can heal without surgery if it is immobilized appropriately and treated adequately. Rehabilitation is also an essential part of healing from a sprained ankle. Ankle stretches and ankle-strengthening exercises can significantly improve your success and help you get back to normal activities. You will go through three phases of healing as you recover from a sprained ankle:
- First: Resting and protecting the ankle while reducing swelling using the RICE protocol for one week.
- Second: Restoring range of motion, strength, and flexibility for one to two weeks.
- Third: Gradually returning to activities that do not require turning or twisting of the ankle and performing stretching exercises.
Once the ankle is pain-free, you can start doing strengthening exercises, followed by getting back into activities like tennis, basketball, or football. The recovery phases can collectively take weeks to months, depending on the severity of your sprain.
People who sprain their ankles have an increased risk of getting injured again, so make sure you fully rehabilitate your sprained ankle before resuming regular activities. The final phase of recovery from an ankle sprain is working on balance. Having good balance and proprioception will help keep you from suffering future ankle sprains.
Walking on a Sprained Ankle
Depending on the grade of your injury, you may be given a removable plastic device, such as a walking boot or air splint, to wear while you recover. To help you recover quickly and safely, consider crutches and knee scooters to help with mobility while you rest the injury.
Traditional Crutches
While crutches are inexpensive and effective, they can cause pain in your hands, arms, wrists, and forearms. When using crutches to walk or stand, you won’t be able to use your hands and arms, making everyday tasks like carrying something from one room to the other very difficult. However, crutches will help you keep your leg somewhat elevated, which is also one of the benefits of knee scooters.
Knee Scooters or Knee Walkers
Knee scooters are becoming increasingly popular due to the general dislike of crutches. With knee scooters, you kneel on a platform and roll by propelling yourself with your good foot. A knee scooter is efficient for covering distances but doesn’t work well on uneven terrain or tight places. Knee scooters are heavy and bulky as well. They are restrictive when performing daily activities and you cannot use them on stairs. You will also need both hands to operate a knee scooter.
Ankle Sprain Prevention Tips
Unfortunately, people who sprain their ankles are more prone to re-injury, but there are ways to prevent future ankle sprains. We can’t always predict or prevent injuries from happening, but we can take measures to ensure we have a lower risk as we participate in physical activities.
1. Warm Up
Lightly stretch your muscles, but don’t force a stretch by bouncing. Perform the movement until you can create tension in the tendons and muscles, and hold for 15 to 20 seconds. Jog in place for a few minutes to warm up before starting any physical activity.
2. Conditioning
Conditioning your muscles for the activities you’re participating in is essential. The amount of time spent on the activity should gradually increase muscle strength and mobility. Cross-training can also help.
3. Choose Athletic Shoes Specifically for Your Foot Type
This is a very important part of preventing foot and ankle injuries, even for people who don’t participate in sports. People with low arches should choose shoes that provide support in both the front of the shoe and under the arch. The back of the shoe should be very stable. People with high arches should choose shoes with more cushion and softer platforms. When possible, use sport-specific shoes that protect your ankles as well.
4. Replace Athletic Shoes Regularly
Most people should replace their shoes every six months. Athletes, however, should replace their shoes far more often. So when the heel of your shoe feels worn and soft, or the tread is thin, that is a reminder to get new footwear.
Bottom Line
The first 24–48 hours after an ankle sprain are the most uncomfortable, but symptoms can be relieved with at-home treatment, including icing and elevating the injury to reduce swelling. Rebuilding strength in your ankle after a sprain can help prevent future sprains. Always pay attention to the surfaces you’re walking or exercising on to avoid accidental trips and falls that could lead to sprains.
