Ankle Sprain
A stretch or tear of the ligaments that support the ankle
Quick Facts
- Type: Soft-tissue (ligament) injury
- Common cause: Rolling or twisting the foot
- Main symptoms: Pain, swelling, bruising, instability
- First aid: Rest, ice, compression, elevation (RICE)
Overview
An ankle sprain happens when the strong bands of tissue that hold the ankle bones together, called ligaments, are stretched or torn. Most sprains affect the ligaments on the outer side of the ankle and occur when the foot rolls inward beneath the leg. It is one of the most common injuries in sports and everyday life.
Sprains are graded by severity: a mild (grade 1) sprain involves overstretching with tiny tears, a moderate (grade 2) sprain involves a partial tear with more swelling and instability, and a severe (grade 3) sprain is a complete tear. Most ankle sprains heal with self-care and time, but a proper diagnosis is important to rule out a fracture and to guide recovery so the ankle does not become weak or prone to repeat injury.
Symptoms
Symptoms appear soon after the injury and vary with how badly the ligament is damaged.
- Pain, especially when bearing weight or pressing on the ankle
- Swelling, sometimes developing quickly
- Bruising that may spread down toward the foot
- Tenderness over the injured ligament
- A feeling of instability or the ankle giving way
- Reduced range of motion or stiffness
Some people hear or feel a pop at the moment of injury. Pain directly over a bone, inability to bear any weight, or a visible deformity may suggest a fracture rather than a simple sprain and should be evaluated by a clinician.
Common Causes
Ankle sprains occur when the joint is forced beyond its normal range of motion, stretching or tearing the ligaments.
- Rolling the ankle: The foot turning inward or outward awkwardly, often on uneven ground.
- Sports movements: Jumping and landing badly, pivoting, or stepping on another player's foot.
- Missteps: Stepping off a curb, tripping, or walking on an uneven surface.
- Falls: Twisting the ankle during a slip or fall.
People with previous sprains, weak supporting muscles, or loose ligaments are more likely to sprain the same ankle again.
Risk Factors
- Sports that involve jumping, cutting, or running on uneven surfaces
- A history of prior ankle sprains
- Poor balance or weak ankle and leg muscles
- Improper or worn footwear, including high heels
- Walking or running on uneven terrain
- Naturally loose or flexible ligaments
Diagnosis
A clinician examines the ankle, checking for swelling, bruising, tenderness, and stability, and asks how the injury happened. Imaging is used mainly to rule out a broken bone.
- Physical exam: Gentle movement and pressure to find the injured ligament and assess stability.
- X-rays: Ordered when a fracture is suspected, based on the location of pain and ability to bear weight.
- MRI: Occasionally used for severe or slow-healing injuries to assess ligaments and surrounding tissue.
Treatment
Most ankle sprains are treated without surgery. Early care focuses on protecting the joint and reducing swelling, followed by a gradual return to movement and strength.
- RICE: Rest, ice, compression with a wrap, and elevation, especially in the first days.
- Pain relief: Over-the-counter pain relievers can ease discomfort and swelling.
- Support: A brace or wrap helps stabilize the ankle while it heals.
- Gradual movement: Gentle motion and weight-bearing as tolerated, rather than prolonged complete rest, supports recovery.
- Rehabilitation: Exercises to restore strength, flexibility, and balance help prevent future sprains.
Severe (grade 3) sprains may need a longer period of immobilization, formal physical therapy, and rarely surgery if the ankle remains unstable.
Prevention
- Warm up and stretch before activity
- Strengthen the ankle and calf and practice balance exercises
- Wear supportive footwear appropriate for the activity
- Use a brace or tape if you have a history of sprains
- Be cautious on uneven or slippery surfaces
- Increase the intensity of new activities gradually
When to See a Doctor
See a doctor if you cannot bear weight, the ankle is very swollen or painful, or it has not improved within a few days. Seek prompt or emergency care for:
- Inability to put any weight on the foot
- Severe pain or tenderness directly over a bone
- A visible deformity or the ankle looking out of shape
- Numbness, tingling, or a cold, pale foot
- Repeated sprains or a persistent feeling that the ankle gives way
Frequently Asked Questions
How long does a sprained ankle take to heal?
A mild ankle sprain often improves within 1 to 3 weeks, while moderate to severe sprains can take several weeks or longer. Healing time depends on the grade of injury and how well you rest and rehabilitate the ankle. Returning to sport too soon raises the risk of re-injury.
How can I tell if my ankle is sprained or broken?
Both cause pain, swelling, and bruising. Pain directly over a bone, inability to bear any weight, or a visible deformity points more toward a fracture, while a sprain usually involves tenderness over the soft tissue. Because they overlap, an X-ray is the reliable way to tell them apart.
Should I keep walking on a sprained ankle?
Gentle, gradual weight-bearing as pain allows generally helps recovery more than complete rest, but you should avoid forcing painful movement. If you cannot bear weight at all, have the ankle checked to rule out a fracture. A brace or wrap can provide support during recovery.
Why does my ankle keep getting sprained?
Repeated sprains often happen when the ligaments and surrounding muscles remain weak or the ankle has lost some of its sense of position after a prior injury. Strengthening and balance exercises, supportive footwear, and bracing can reduce the chance of spraining the same ankle again.
When should I see a doctor for an ankle sprain?
See a clinician if you cannot put weight on the foot, the swelling or pain is severe, there is numbness or deformity, or the ankle has not improved after a few days. These may signal a fracture or a severe ligament tear that needs more than basic home care.
References
- American Academy of Orthopaedic Surgeons (OrthoInfo). Sprained Ankle.
- Mayo Clinic. Sprained ankle.
- MedlinePlus, U.S. National Library of Medicine. Ankle injuries and disorders.
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS).