A sprained ankle is a common injury that occurs when the tissue that connects your ankle bones and supports your ankle (ligaments) is torn or stretched beyond its limits, often after a fall, ankle roll or twist.
A sprained ankle is when the ligaments in your ankle are torn, while broken ankle or ankle fracture is when one or more of the bones in your ankle break. Severe sprains and fractures have similar symptoms (pain, swelling, bruising, tenderness) and are both caused by twisting or rotating your ankle, tripping or falling, or trauma to your ankle. Sprains heal faster, but it can take up to six weeks for a broken ankle to heal.
Who does a Sprained Ankle affect?
Anyone, at any age, can sprain their ankle. Sprains are most common in athletes during sporting events, but can happen during everyday activities as well.
There are three types of ankle sprains based on how much ligament damage occurred:
- Grade 1 (Mild). The ligament fibers stretched slightly or there is a very small tear. Your ankle will have minor swelling and tenderness to the touch.
- Grade 2 (Moderate). The ligament is torn, but it isn’t a complete tear. Your ankle has swelling over the injury and it hurts to move.
- Grade 3 (Severe). The ligament is torn completely. Your ankle has significant swelling, the injury is painful and walking is difficult.
Symptoms of a sprained ankle?
The symptoms of a sprained ankle include:
- Pain, especially when putting weight on your ankle.
- Tenderness to the touch.
- Difficulty walking.
Some people can recall the exact moment a sprain occurred, while others have to really think about what they were doing and how it impacted the ankle.
Common causes of ankle sprain include:
- walking or running on uneven surfaces
- falling down
- sports that require rolling or twisting of the foot or cutting actions
- jumping, then landing hard on your foot
- someone stepping or landing on your foot
These movements and activities involve the foot or lower leg experiencing a sudden twisting force or roll, which forces the ankle joint out of normal position. When this happens, you can sprain a ligament(s) in this area.
Another cause of ankle sprains is a previous sprain. According to the AAOS, once you experience an ankle sprain, it’s more likely to happen again, especially if the ligaments do not heal.
Diagnosis and Tests
Your healthcare provider will diagnose your sprained ankle after a physical examination of your foot and ankle to identify your range of motion and determine which ligaments are affected. The physical exam is typically followed by an imaging test, like an X-ray.
How do I know if I sprained my ankle?
If you fell or twisted your ankle, and the injury causes you pain, swelling, bruising and you have trouble walking, you can assume that you have a sprained ankle. Visit your healthcare provider and they’ll assess the injury, confirm the diagnosis and offer a treatment plan.
Management and Treatment
For the majority of ankle sprains, healthcare providers recommend using the PRICE method for the first 24-48 hours after injury. PRICE stands for protection, rest, ice, compression and elevation.
- Protection – Use crutches or apply a splint or brace to limit use of your injured ankle.
- Rest – Limit physical activities that may cause stress to the sprain (no running, jumping, exercising).
- Ice – Apply ice or a cold pack in a towel to your ankle in 20-minute increments to reduce swelling.
- Compression – Gently wrap your ankle in an elastic bandage to help decrease swelling.
- Elevation – Raise your ankle on pillows while you’re sitting or lying down so that it’s higher than your heart.
If your sprain is very painful and swollen or you’re having trouble walking and putting pressure on your ankle, visit your healthcare provider for treatment.
Anti-inflammatory drugs, like ibuprofen, may help alleviate pain and swelling from the sprain.
Swelling normally doesn’t appear immediately. It could take several hours to develop. If you develop swelling, it could last up to 48 hours for a mild to moderate sprain. Swelling on severe sprains may last longer until your torn ligament heals.
Can I walk on a sprained ankle?
Your healthcare provider may recommend the use of crutches, a boot or a brace/splint to keep weight off of your ankle and give your ankle support and stability (protection). Putting too much pressure on a sprained ankle could worsen the sprain, cause more discomfort and prolong healing time.
Your healthcare provider may recommend physical therapy to help you regain strength and mobility. Physical therapy is common for athletes, so you can return to your sport once the injury heals. There’s evidence to support physical therapy as important to proper healing.
Surgery is rare to treat an acute ankle sprain. If you have long-term problems with your ankle like instability — rolling your ankle repeatedly — then your healthcare provider may recommend surgery.
Do ankle sprains heal on their own?
Most sprains heal on their own, but rebuilding strength in your ankle can help prevent future injuries. If you don’t allow your ankle ligaments time to heal, you may have long-lasting instability (chronic ankle sprains) or repeat ankle sprains. If your symptoms continue for more than four to six weeks after injury and you still feel weakness when walking on your foot, you may have a chronic ankle sprain.
In order to prevent ankle sprains, you can:
- Maintain good muscle strength by exercising regularly.
- Warm up and stretch before exercise and physical activity.
- Pay attention to uneven surfaces where you’re walking or running.
- Slow down or stop if you feel tired during activities or exercise.
After giving your ankle time to heal and treating the sprain according to your healthcare provider’s recommendations, you’ll be able to get back to regular activities. Your prognosis depends on your commitment to building strength back in your ankle through exercises and rehabilitation. If your ankle hasn’t healed completely or you stopped the strengthening exercises, your injured ligament could weaken and put you at risk for future ankle sprains.
How long does a sprained ankle take to heal?
The recovery time for a sprained ankle varies depending on the severity of your injury. It may take anywhere from two weeks to heal a minor sprain and anywhere from six to 12 weeks to heal a severe sprain.
After treating your sprain with the PRICE method, you’ll need to build back flexibility and strength in your ankle. Perform exercises recommended by your healthcare provider or physical therapist to improve your range of motion.
Physical therapy exercises include:
- Motion-controlled movements without resistance.
- Strength training for the muscles and tendons in the front and back of your legs.
- Balance training (proprioception) to prevent future sprains.
- Endurance and agility exercises for calf and ankle strength.
Early exercises in your treatment plan will not require you to turn or twist your ankle, but over time, you’ll be able to get back to regular activities that may require sudden turns (like playing football or basketball).
When should I see my healthcare provider?
You should visit your healthcare provider for severe sprain evaluation if you can’t walk after an injury and your swelling and pain haven’t improved or have gotten worse 24-48 hours after the sprain occurred.
What questions should I ask my doctor?
- How severe is my sprain?
- Is this a sprain or is my ankle broken?
- Do you recommend I use crutches?
- Should I visit a physical therapist to improve strength in my ankle?
What is a high ankle sprain?
A high ankle sprain is a sprain in the upper ligaments of your ankle, above the ankle itself. These ligaments are attached to the fibula and the tibia, stabilizing the entire area for activities like running and walking.
When you damage or tear those ligaments — often due to rotating or twisting your ankle — you’re experiencing a high ankle sprain. This type of sprain doesn’t occur as often as a sprain in the lower part of the ankle.
High ankle sprain vs low ankle sprain
Low ankle sprains are the most common type of ankle sprain. They happen when you rotate or twist your ankle toward the inside of your leg, which causes the ligaments on the outside of your ankle to tear or stretch.
High ankle sprains can happen when you have a fractured ankle bone. Sometimes, these can happen when the deltoid ligaments, the ligaments on the inside of your ankle, have been torn. You might feel pain in the deltoid area, in the ligaments of the high ankle, or even in the fibula.
High ankle sprains are also called Syndesmotic Ankle Sprains after the bone and ligaments involved.
The amount of time it takes for an ankle sprain to heal depends on the severity of the injury. Generally, it will take a minimum of 3 to 4 weeks and up to 6 months for an ankle sprain to heal. That’s why getting a proper diagnosis and treatment plan for an ankle sprain is critical. Working with your physician and a skilled physical therapist on the initial treatment as well as the long-term rehab can ensure that you are moving in the right direction.