Ankle Sprain Care and Recovery

Understanding Ankle Sprains

Learn what causes ankle sprains, how they present, and when to seek care.

Ankle Sprain Evaluation and Treatment

An ankle sprain refers to tearing of the ligaments of the ankle. The most common ankle sprain occurs on the lateral or outside part of the ankle. This is an extremely common injury which affects many people during a wide variety of activities. It can happen in the setting of an ankle fracture (i.e. when the bones of the ankle also break). Most commonly, however, it occurs in isolation.

Patients report pain after having twisted an ankle. This usually occurs due to an inversion injury, which means the foot rolls underneath the ankle or leg. It commonly occurs during sports. Patients will complain of pain on the outside of their ankle and various degrees of swelling and bleeding under the skin (i.e. bruising). Technically, this bruising is referred to as ecchymosis. Depending on the severity of the sprain, a person may or may not be able to put weight on the foot.

Sprains are generally graded by severity. A mild sprain involves stretching of the ligament fibers, a moderate sprain involves partial tearing, and a severe sprain involves complete tearing of one or more ligaments. Because a sprain can occur alongside a fracture, imaging is often used to rule out broken bones and assess the extent of ligament injury.

If you have twisted your ankle and are experiencing pain, swelling, bruising, or difficulty bearing weight, a prompt evaluation helps confirm the diagnosis and guide treatment. Early care reduces the risk of chronic instability and helps you return to normal activity more safely.

Risk Factors and Preventing Reinjury

Ankle sprains occur when the ankle is twisted underneath the leg, called inversion. Risk factors include activities such as basketball and jumping sports, in which an athlete can come down on and turn the ankle or step on an opponent’s foot. Uneven surfaces, improper footwear, and fatigue during activity can also increase the likelihood of a sprain.

Some people are predisposed to ankle sprains. In people with a hindfoot varus, which means that the general nature or posture of the heels is slightly turned toward the inside, these injuries are more common. This is because it is easier to turn on the ankle.

In those who have had a severe sprain in the past, it is also easier to turn the ankle and cause a new sprain. Therefore, one of the risk factors of spraining the ankle is having instability. Those who have weak muscles, especially those called the peroneals which run along the outside of the ankle, may be more predisposed.

After a sprain has healed, targeted strengthening of the peroneal muscles, balance and proprioception training, and appropriate bracing or taping during high-risk activities can help reduce the chance of reinjury. Supportive footwear and gradual return to sport are also important parts of preventing another episode.

Patients who have sustained a previous sprain or who notice recurrent giving way of the ankle should be evaluated for chronic ankle instability, as ongoing symptoms can often be improved with the right combination of rehabilitation and, in some cases, further treatment.