Ankle Sprains

What is an ankle sprain?

An ankle sprain is a stretched or torn ligament in your ankle. Ligaments connect your bones at the joint and keep them from moving out of place. There are three grades of ankle sprains. Grade 1 is mild, grade 2 is moderate, and grade 3 is a severely sprained ankle. The grade of your sprain is based on the damage to your ligaments. If you have a higher-grade sprain, you might have torn several ligaments.

Symptoms of an ankle sprain

Symptoms of ankle sprains include:

  • pain or tenderness
  • swelling
  • bruising
  • stiffness
  • coldness or numbness in your foot
  • inability to walk or put weight on your foot.

What causes an ankle sprain?

Ankle sprains often occur during physical activity. Sometimes they can happen when you walk or run on a rough surface. You could fall, land on your ankle wrong, or twist your ankle.

How is an ankle sprain diagnosed?

Your doctor can diagnose an ankle sprain. They will examine your ankle and ask about your symptoms and activity. They may take an X-ray to confirm your ankle isn’t broken or fractured. Once they diagnose the sprain, they will determine what grade it is. This will play a role in the type of treatment you receive.

Can an ankle sprain be prevented or avoided?

There are ways to help prevent an ankle sprain. You can do exercises to strengthen your ankle and the muscles around it. These exercises stabilize your ankle and improve your balance. It also is important to stretch before and after you exercise.

Whether you’ve had an ankle sprain before or not, try to wear supportive shoes. This helps prevent your foot from twisting or your ankle joint from moving out of place.

How to treat a sprained ankle

You can treat a lot of ankle sprains at home. Doctors recommend the RICE approach, listed below.

  • Rest: All ankle sprains require a period of rest. The length of time will depend on your grade of sprain. Your doctor can help you with a timeline. Use crutches if it hurts to put weight on your foot.
  • Ice: Ice helps decrease swelling, bruising, pain, and muscle spasms. Putting ice on your ankle is helpful, but you need to be careful. The cold can damage your nerves if you leave ice in place too long. You should only use ice for up to 20 minutes at a time. If your skin feels numb, it’s time to remove the ice. Use ice treatments every 2 to 4 hours for the first 3 days after your injury. Ice treatments can consist of ice packs, ice baths, or ice massages.
    • To make an ice pack, partly fill a plastic bag with ice. Put a thin, damp cloth on your ankle to create a layer between your skin and the ice. Wrap an elastic bandage around the ice pack to hold it in place.
    • For an ice bath, fill a large bucket with water and ice. Place your ankle in the bucket until the skin starts to get numb.
    • Ice massages can work well for small areas. Freeze water in 4- to 8-ounce Styrofoam (coffee) cups. Tear the top part of the cup away from the ice. Hold the covered end and slowly rub the ice over the sprained area in a circular motion. Don’t hold the ice on one spot for more than 30 seconds.
  • Compression: You can wrap your sprained ankle to avoid swelling and bruising. You might need to do this for several days or a week after your injury. Start by cutting out a horseshoe-shaped pad from 1 x 4- to 3 x 8-inch-thick felt. Put this pad around the outside of your ankle joint on both sides of your foot. The open end should face up. Then wrap an elastic bandage, such as an Ace bandage, in a “figure-eight” pattern. Leave your heel exposed. Reinforce your wrap with 21 x 2-inch adhesive tape over the elastic bandage. Your doctor can show you how to do this. The ankle shouldn’t be wrapped so tight that it cuts off your blood flow.
  • Elevation: Raise your ankle at or above the level of your heart. This helps prevent the swelling from getting worse and reduces bruising. Try to keep your ankle elevated for about 2 to 3 hours a day.

To help relieve pain, you can take over-the-counter medicine. Try acetaminophen (Tylenol) or ibuprofen (Advil, Motrin, or Nuprin).

You’ll need additional treatment for a higher-grade ankle sprain. Your doctor might give you a cast, boot, or brace to wear on your ankle. This will keep your ligaments and joint in place while they heal. It limits motion, provides protection, and helps reduce pain. You may need to wear it for 2 to 6 weeks.

Physical therapy also is an important part of ankle sprain treatment. The amount and length of time will depend on your grade and state of health.

Living with a sprained ankle

Ankle sprains are common problems, but they do heal. However, you may not be able to return to normal activities right away. It will depend on the grade of your ankle sprain. If your sprain is mild, it might only be 1 to 3 days. If your sprain is moderate or severe, it could be a few weeks. Your doctor can help provide a timeframe for your condition. Once you return, you still may need to wear an ankle brace or bandage for support and protection.

Your doctor or therapist also will provide a list of ankle exercises to do. This will help strengthen your muscles and prevent future sprains. Try the following exercises:

  • Ankle circles: Sit on the floor with your legs stretched out in front of you. Move your ankle from side to side, up and down, and around in circles. Do 5 to 10 circles in each direction at least 3 times per day.
  • Alphabet letters: Using your big toe as a “pencil,” write the letters of the alphabet in the air. Do the entire alphabet 2 or 3 times.
  • Toe raises: Flex your toes back toward you while keeping your knee as straight as you can. Hold for 15 seconds. Do this 10 times.
  • Heel raises: Point your toes away from you while keeping your knees as straight as you can. Hold for 15 seconds. Do this 10 times.
  • In and out: Turn your injured foot inward until you can’t turn it anymore and hold for 15 seconds. Straighten your foot again. Turn it outward until you can’t turn it anymore and hold for 15 seconds. Do this 10 times in both directions.
  • Resistance in and out: Sit on a chair with your leg straight in front of you. Tie the ends of a large elastic exercise band together to make a knot. Wrap the end of the band around the chair leg. Wrap the other end around the bottom of your injured foot. Keep your heel on the ground and slide your foot outward and hold for 10 seconds. Put your foot in front of you again. Slide your foot inward and hold for 10 seconds. Repeat at least 10 times each direction 2 or 3 times per day.
  • Step up: Put your injured foot on the first step of a staircase and your other foot on the ground. Slowly straighten the knee of you injured leg while lifting your other foot off the ground. Return to your starting position. Do this 3 to 5 times at least 3 times per day.
  • Sitting and standing raises: Sit in a chair with your feet on the ground. Slowly raise your heels while keeping your toes on the ground. Return your heels to the floor. Repeat 10 times at least 2 or 3 times per day. As you get stronger, you can stand on your feet instead of sitting in a chair and raise your heels.
  • Balance Exercises: Stand and place a chair next to your uninjured leg to balance you. To start, stand on your injured foot for 30 seconds. You can slowly increase this to up to 3 minutes at a time. Repeat at least 3 times a day. To increase the difficulty, repeat with your eyes closed.

Questions to ask your doctor

  • What grade of ankle sprain do I have?
  • Will I need to wear a cast, boot, or brace? If so, for how long?
  • When can I return to my regular activities?
  • Besides doing special exercises, how can I prevent re-spraining my ankle?