Ankle Injury
Damage to the ligaments, tendons, or bones of the ankle
Quick Facts
- Type: Musculoskeletal injury
- Common cause: Twisting or rolling the ankle
- Most common type: Sprain (stretched or torn ligament)
- First aid: Rest, ice, compression, elevation (RICE)
Overview
An ankle injury is any damage to the structures that make up and support the ankle joint, including the bones, ligaments, tendons, and other soft tissues. The most common ankle injury is a sprain, in which the ligaments that hold the bones together are stretched or torn. More forceful injuries can cause a fracture (break) in one of the ankle bones, a tendon injury, or a dislocation.
Ankle injuries are among the most common musculoskeletal injuries and happen during sports, walking on uneven ground, falls, and accidents. Most mild and moderate injuries heal well with simple home care, but it is important to recognize the signs of a fracture or severe injury that needs medical evaluation.
Symptoms
Symptoms depend on the type and severity of the injury but commonly include:
- Pain, often immediate, that worsens with weight-bearing
- Swelling around the ankle
- Bruising
- Tenderness when the area is touched
- Stiffness or limited movement
- A feeling of instability or that the ankle may give way
An inability to put weight on the foot, a popping sound at the time of injury, an obvious deformity, or numbness suggest a more serious injury such as a fracture or significant ligament tear.
Causes
Ankle injuries occur when the joint is forced beyond its normal range of motion or absorbs excessive force:
- Rolling or twisting: Turning the foot inward or outward stretches or tears the ligaments, causing a sprain.
- Falls and landings: Landing awkwardly from a jump or stepping off a curb.
- Direct impact: A blow to the ankle during sports or an accident.
- Uneven surfaces: Walking or running on irregular ground.
- Sudden direction changes: Common in sports such as basketball, soccer, and running.
Risk Factors
- Participation in sports that involve jumping, cutting, or running
- A previous ankle sprain, which weakens the ligaments
- Poor footwear or worn-out shoes
- Walking or working on uneven surfaces
- Weak or inflexible ankle muscles
- Being overweight, which adds load to the joint
Diagnosis
A clinician examines the ankle for swelling, tenderness, bruising, range of motion, and stability, and asks how the injury happened. To determine whether a bone is broken:
- X-rays: The main test to check for fractures, guided in part by whether you can bear weight and where the tenderness is.
- MRI or ultrasound: Used to assess ligament and tendon damage when needed.
- CT scan: For complex fractures, especially before surgery.
Treatment
Most mild and moderate ankle injuries are treated conservatively, often beginning with the RICE approach:
- Rest: Avoid putting weight on the ankle until pain allows.
- Ice: Apply cold packs for the first day or two to reduce swelling.
- Compression: Use an elastic bandage for support.
- Elevation: Keep the ankle raised above heart level when possible.
Pain relievers, a brace or supportive footwear, and gradual return to activity help recovery. Physical therapy restores strength, balance, and flexibility and lowers the chance of re-injury. Fractures may need a cast or surgery, and severe ligament tears are sometimes repaired surgically.
Prevention
- Warm up and stretch before exercise
- Wear supportive, well-fitting shoes appropriate for your activity
- Strengthen the ankle and improve balance with targeted exercises
- Use an ankle brace or tape if you have had previous sprains
- Be cautious on uneven or slippery surfaces
- Increase activity gradually and avoid overtraining
When to See a Doctor
See a doctor if pain and swelling are severe, do not improve within a few days, or you cannot walk comfortably. Seek prompt or emergency care if:
- You cannot bear any weight on the ankle
- The ankle looks deformed or out of place
- There is numbness, tingling, or the foot is pale or cold
- You heard a pop and the joint feels unstable
- The skin is broken over the injury
Frequently Asked Questions
How can I tell if my ankle is sprained or broken?
Both cause pain and swelling, but a fracture is more likely if you cannot bear any weight, there is a deformity, or you heard a snap. Because they can look similar, an X-ray is often needed to be sure, especially if symptoms are severe or not improving.
What is the best first aid for an ankle injury?
The RICE approach works well for most sprains: rest the ankle, apply ice for the first day or two, use compression with an elastic bandage, and elevate the foot above heart level. Avoid heat and alcohol early on, which can increase swelling.
How long does an ankle sprain take to heal?
A mild sprain often improves within one to three weeks, while moderate to severe sprains may take six weeks or longer. Returning to activity too soon or skipping rehabilitation increases the risk of re-injury.
Should I keep walking on a sprained ankle?
Gentle, pain-free movement and gradually returning to weight-bearing usually help recovery, but you should avoid forcing through significant pain. If you cannot put weight on the ankle at all, see a clinician to rule out a fracture.
Why do some people keep spraining the same ankle?
A previous sprain can leave the ligaments looser and weaken the muscles and balance around the joint, making re-injury more likely. Strengthening exercises, balance training, and bracing can help reduce repeat sprains.
References
- American Academy of Orthopaedic Surgeons (OrthoInfo). Sprained ankle.
- Mayo Clinic. Sprained ankle — Symptoms and causes.
- MedlinePlus, U.S. National Library of Medicine. Ankle injuries and disorders.
- Cleveland Clinic. Ankle injuries.