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Ankle Sprains

Last Updated April 2022 | This article was created by editorial staff and reviewed by Leisa Bailey, MD

What is an ankle sprain?

Your ankle is the joint that connects your leg to your foot. This joint is made up of bones and connected to three ligaments. These ligaments keep the bones from moving out of place. An ankle sprain happens when one or more of those ligaments is stretched or torn.

Sprained ankles are divided into three grades, based on severity.

  • Grade 1: Mild sprain. It’s the most common. In this case, the ligament is stretched, not torn. You may experience minor pain and stiffness, but you can still get around.
  • Grade 2: Moderate sprain. In this case, one or more ligaments are partially torn. Your ankle will likely be swollen, you will feel moderate pain, and it will be hard to stand on that foot.
  • Grade 3: Severe sprain. Here, one or more ligaments are completely torn. Your ankle will be unstable, the pain will be severe, and you won’t be able to move your ankle.

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 that foot

With mild sprains, you may have stiffness while walking. That should get better in a few days to a few weeks. People who have moderate and severe sprains may have limits for several weeks. And they may have ankle pain for a year or more.

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. The unevenness can make you fall, land on your ankle wrong, and sprain it.

People who have high arches in their feet or weak muscles are more likely to sprain their ankles. If you’ve sprained your ankle before, you’re more likely to sprain it again.

How is an ankle sprain diagnosed?

Your doctor can diagnose an ankle sprain. He or she will examine your ankle and ask about your symptoms and activity. The doctor may take an X-ray to confirm your ankle isn’t broken or fractured. Once they diagnose the sprain, your doctor will determine the grade. This will determine the type of treatment you receive. If your ankle doesn’t get better, your doctor may request an MRI. This is a type of image that allows him or her to see the ligaments inside your ankle.

Can an ankle sprain be prevented or avoided?

There are ways to help prevent an ankle sprain. Certain exercises can strengthen your ankle and the muscles around it. These exercises stabilize your ankle and improve your balance. It is also important to stretch before and after you exercise. Your doctor will show you which exercises are best.

Wear supportive shoes, whether you’ve had an ankle sprain before or not. This helps prevent your foot from twisting or your ankle joint from moving out of place. You may also find it helpful to wear an ankle brace when playing sports, running or jogging. This may add stability to your ankle.

How to treat a sprained ankle

You can treat a lot of ankle sprains at home. Doctors recommend the RICE approach (Rest, Ice, Compression, and Elevation), listed below.

  • Rest: All ankle sprains require rest. The length of time will depend on the grade of sprain. Your doctor can help you with a timeline. You may need to 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 be careful. Place a thin, damp cloth on your ankle before applying the ice. That will help protect your skin from frostbite. Also, cold can also 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.
  • Compression: Wrap your sprained ankle to avoid swelling and bruising. You might need to do this for several days or a week after your injury. Your doctor can show you the best way to do this.
  • Elevation: Raise your ankle at or above the level of your heart. This prevents the swelling from getting worse and reduces bruising. Keep your ankle elevated for 2 to 3 hours a day.

To relieve pain, your doctor may suggest you take over-the-counter medicine. Examples include acetaminophen (brand name: Tylenol) or ibuprofen (brand names: 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. This will keep the 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. Your doctor may also refer you to physical therapy. The amount and length of time of treatment will depend on the grade of your sprain and your state of health.

Living with a sprained ankle

Ankle sprains are common problems, but they do heal. However, depending on the grade of your sprain, you may not be able to return to normal activities right away. Your doctor can provide a time frame for your situation. Once you return to regular activities, you still may need to wear an ankle brace or bandage for support and protection.

Your doctor or physical therapist may provide a list of ankle exercises for you to do. This will help strengthen your muscles. He or she will tell you when to start the exercises and how long to do them. Depending on the severity of the sprain, you may need to do them for several weeks. It’s important you do the exercises for the amount of time your doctor says. This will help prevent future sprains.

Questions to ask your doctor

  • What grade of ankle sprain do I have?
  • Do I need to wear a cast, boot, or brace? If so, for how long?
  • How long until I can return to my regular activities?
  • What can I do to prevent re-spraining my ankle?
  • What should I look for in supportive shoes?
  • What kind of ankle brace should I wear when playing sports?
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